Maternal mortality--a ten-year study.

Maternal deaths in Kasturba Hospital, during the 10-year period from January 1989 to December 1998 were studied. A total of 419 deaths were recorded among 1,12,133 deliveries, with an average maternal mortality rate of 360. The year wise maternal mortality rate showed an almost consistent decline from 468 to 190 over the decade. Almost all the deaths (95%) occurred among unbooked gravidas. Indirect causes claimed 62.5% lives while 33.8% were due to direct obstetric causes and 15 (3.6%) deaths were due to coincidental causes. Severe anaemia was the largest killer, causing 31% of total deaths. Majority (65.6%) of deaths occurred in the postnatal period. Most of the deaths could have been prevented by better community participation, antenatal care, iron-folate prophylaxis and timely medical care.