Shehla Sami, Shahnaz Naseer Baloch.
Maternal Mortality in Balochistan: A challenge for the Obstetricians.
J Coll Physicians Surg Pak Jan ;12(8):468-71.

Objective: To identify the main causes contributing to high maternal mortality rate at Quetta, Pakistan Design: An analytical, hospital-based study. Place and Duration of Study: From January 1996 to December 2000 at Gynaecology Unit-I, Sandeman (Provincial) Hospital, Quetta, Pakistan. Patients and Methods: Referral level hospital surveyed by questionnaires, using verbal autopsy of the attendants and the next of kin of the dying women. The questionnaire contained specific informations regarding medical and obstetrical complications leading to the death of mothers. All the relatives were required to answer the supplied questionnaires independently and a final conclusion, regarding the cause of death, was drawn by the senior obstetrician of the department on the basis of verbal autopsy report. Results: Maternal mortality ratio, measuring the risk of death specifically during pregnancy, was calculated to be 560/100,000 LB (live births). Obstetrical hemorrhages accounted for 43 cases (42%), obstructed labour/ruptured uterus were the second most common with 22 cases (21%). Direct obstetrical deaths were 101 (99%) out of 102 maternal deaths, one indirect death, excluding 2 fortuitous deaths due to carcinoma of cervix and ovary. Out of direct deaths, 61 (60%) were in the postpartum period. Conclusion: A high proportion of potentially preventable maternal deaths indicate the need for improvements in education for both patient and health care provider, if we are to reduce maternal mortality ratio (MMR) to half by the end of this century, which is the goal of safe motherhood initiative (SMI).

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