Trends in maternal mortality due to haemorrhage: two decades of Indian rural observations.
Obstetric haemorrhage continues to be a major cause of maternal mortality. Our analysis of records of over a period of 20 years from April 1982 to March 2002 reveals that it was a contributory cause of maternal mortality in 19.9% of cases. The majority of deaths, (65%) had occurred within 24 hours of admission and in 47.5% of cases there was severe anaemia on admission; 17.5% had died due to an atonic PPH, which was the largest category, followed by ruptured uterus (15%), abruptio placenta (15%) and retained placenta (12.5%). Deaths due to obstetric haemorrhage because of a ruptured uterus, retained placenta and abortion have decreased from 22.22% between 1982 and 1987 to zero in the last 5 years and an increase was seen in deaths due to haemorrhage because of gestational trophoblastic neoplasia and ectopic pregnancy, from 1.69% to 4.87%, unclassified haemorrhage 1.96% to 7.31% and placenta praevia from zero between 1982 and 1987 to 4.87% between 1997 and 2002.
Chhabra
S
S
Department of Obstetrics and Gynaecology, Mahatma Gandhi Institute of Medical Sciences, Maharashtra, India. chhabra@rediff.com
Sirohi
Ritu
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D005260:Female; D005865:Gestational Age; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality*; D006801:Humans; D007194:India / Q000453:epidemiology; D008423:Maternal Age; D008428:Maternal Mortality / Q000639:trends*; D010298:Parity; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000401:mortality*; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011295:Prenatal Care / Q000592:standards / Q000639:trends; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population; D012720:Severity of Illness Index; D016019:Survival Analysis