Trends in maternal mortality at a university hospital in Turkey.
OBJECTIVE
To highlight recent trends in maternal mortality in Hacettepe University Hospital.


METHODS
A retrospective clinical analysis of 117 maternal deaths between 1968 and 1992.


RESULTS
The overall maternal mortality ratio was 180/100,000 (108/59,993). In terms of 5-year periods, the maternal mortality ratio declined from 417.7 in 1968-72 to 73.7 in 1988-92. Infection was the most common cause of death (59.8%), followed by cardiac disease (8.5%) and hemorrhage (8.5%). Infection related deaths were either due to septic abortion (75.7%) or puerperal sepsis (24.3%). While 73.9% of all deaths were due to infection in 1968-72, this figure contributed only 9.1% of the deaths in 1988-92. When infection, hemorrhage, cardiac disease ad toxemia are investigated together, percentages of their contribution varies from 95.7% in 1968-72 to 54.5% in 1988-92 period.


CONCLUSIONS
Maternal mortality ratios are decreasing significantly in our institution. An another promising finding is the further reduction in direct causes especially in recent years. However, an improvement in the care of pregnant women is necessary to continue this declining trend.
Ayhan
A
A
Department of Obstetrics and Gynecology, Haceffepe University School of Medicine, Ankara, Turkey.
Bilgin
F
F
Tuncer
Z S
ZS
Tuncer
R
R
Yanik
A
A
Kişnisçi
H A
HA
D000031:Abortion, Septic / Q000401:mortality; D000328:Adult; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008428:Maternal Mortality / Q000639:trends*; D011225:Pre-Eclampsia / Q000401:mortality; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000401:mortality; D011645:Puerperal Infection / Q000401:mortality; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology