European Journal of Cardiovascular Medicine

Background: Maternal mortality serves as an indicator of the standard of healthcare within a given community. The maternal mortality ratio is a critical indicator that reflects the standard of reproductive healthcare afforded to expectant mothers. The study aimed to investigate institutional maternal mortality and its underlying causes.  Methods: A hospital-based retrospective study was conducted on 1174 cases of maternal mortality over a four-year period from January 2018 to December 2021 in the Tertiary care center. Data pertaining to all mortalities were gathered from individual case records, facility-based maternal death review forms, and MDR case summaries. Results: The study analysed a total of 1174 deaths. During the study period, the incidence of MMR was 1465 per 1 lakh live births. The age bracket of 20-30 years exhibited the highest incidence of maternal mortalities. The data indicates that a significant proportion of maternal mortality cases occurred in primiparous women (77.17%), in contrast to multi (10.7%) and grand para (12.09%) individuals. The majority of the subjects (52.8%) were not booked, and a significant proportion of them (59.2%) resided in rural regions. The study at hand reveals that maternal mortality was primarily caused by direct and indirect factors, accounting for over 98% of cases. Non-obstetric causes, on the other hand, were responsible for approximately 1.2% of maternal deaths. The predominant direct factors leading to adverse maternal outcomes were haemorrhage (18.2%), encompassing post-partum haemorrhage, ante-partum haemorrhage, and abortion-related haemorrhage. Additionally, hypertensive disorders of pregnancy, including eclampsia, severe preeclampsia, and HELLP syndrome, were the most significant contributors, accounting for 33.9% of cases. Conclusions: The timely detection of high-risk pregnancies, consistent antenatal monitoring, adequate training of healthcare professionals, and prompt referral to tertiary care facilities can significantly decrease mortality rates. There has been a rise in the incidence of measles, mumps, and rubella (MMR) during the ongoing COVID-19 pandemic from 2020 to 2021.