title: Trends in maternal mortality over 29 years in a Kuwait Tertiary Teaching Hospital: signs of progress?
abstract: This study aims at (1) Assessing trends in maternal mortality in kuwait (2) Define strategies for prevention.
  
  
  METHODS
  Retrospective analysis of maternal deaths that occurred among, 55,979 live births at a tertiary hospital, between 1980 and 2009.
  
  
  RESULTS
  There were 14 maternal deaths, and 55,979 live births, giving a maternal mortality rate of 25 per 100,000 live birth. In terms of decades maternal mortality declined from 54.8 in 1980-90 to 28.4 in 1990-2000 and continued to decline to 12.2 in 2000-2009. Thromboembolism (28.6%), Obstetric haemorrhage (21.5%) and Eclampsia (14.3%) were the leading causes of direct deaths. Cardiac disease is the most common cause of indirect deaths (14.3%) followed by H1N1 pneumonia 7.1%. Eclampsia contributed to 40% of deaths, only in the 1980s. Thromboembolism caused 28.6% of deaths, 50% of which were in the last 9 years. Indirect deaths from cardiomyopathies (66.7%) gained prominence in the 1990s. No deaths from puerperal sepsis were reported after the 1980s (14.3%).
  
  
  CONCLUSIONS
  Maternal mortality rates are decreasing significantly (p<0.01) at our institution over the last 29 years. Obstetric haemorrhage and thromboembolism remain important causes of maternal mortality. Substandard care was identified in 70% of Direct and 55% of indirect deaths.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Kuwait University, Kuwait. rachana_chibber@yahoo.co.uk
authors.forename: Rachana
authors.initials: R
authors.lastname: Chibber
authors.forename: Jassim
authors.initials: J
authors.lastname: Al-Hijji
authors.forename: Abdul Razzak
authors.initials: AR
authors.lastname: Al-Adwani
authors.forename: Ahmed
authors.initials: A
authors.lastname: Rammah
authors.forename: Mohamed
authors.initials: M
authors.lastname: Fouda
authors.forename: Eyad
authors.initials: E
authors.lastname: Al-Saleh
authors.forename: M Asiya
authors.initials: MA
authors.lastname: Tasneem
mesh_terms: D002423:Cause of Death / Q000639:trends; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007730:Kuwait / Q000453:epidemiology; D050498:Live Birth / Q000453:epidemiology; D008428:Maternal Mortality / Q000639:trends*; D010298:Parity; D011247:Pregnancy; D058028:Research Report; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D013997:Time Factors