OBJECTIVE: To analyze the risk factors for maternal deaths and to assess if these deaths could have been avoided in our set up. SETTING: Department of Gynaecology and Obstetrics (Unit III), Liaquat University Hospital, Hyderabad, Sindh - Pakistan, from January to December 2005. DESIGN: Descriptive case series. SUBJECTS AND METHODS: Case records of all maternal deaths were reviewed for the demographic features, parity/booking status and other risk factors. Frequencies and percentages were calculated by using SPSS 10.0 in this regard. RESULTS: During this study period, there were 3011 maternity admissions with 2786 live births. Among them, 43 maternal deaths were recorded with maternal mortality ratio (MMR) of 1543 per 100,000 live births. Majority of cases (88.3%) were unbooked, belonged to age group >25 - <35 years with parity <4. Most of patients (90.6%) were anemic with hemoglobin% <10 gm/dl. Most common risk factors found were hypertensive disorders (30.2%), hemorrhage (20.9%) and sepsis (18.6%) respectively. Third phase delay appeared as the most frequently observed delay (62.7%). CONCLUSION: Maternal mortality is very high in our set up due to multiple interrelated factors. This analysis depicts the fact that many of the deaths could have been avoided if appropriate care has been offered to them. Hemorrhage, sepsis and hypertensive disorders are still the leading factors which need top priorities to be focused on. These maternal deaths can be reduced by promoting health awareness, enhancing women's participation in the antenatal program and providing them effective obstetric care at doorstep.
