Maternal mortality: a tertiary care hospital experience in Upper Egypt

Background: Maternal mortality is one of the major challenges which face the developing countries throughout the world. The aim of the study is to assess the causes of maternal mortality at Women Health Hospital, Assiut University, Egypt, and to identify the avoidable ones.Methods: Data were collected from records of patients who presented to and/or delivered at Women Health Hospital between 2009 and 2014. Only cases of maternal mortality were included in this study. In our study, we found 213 maternal deaths at our hospital between 2009 and 2014.Results: The maternal mortality ratio decreased progressively from 2009 to 2014 (228 and 89 per 100000 live birth respectively). Moreover, we found that the indirect causes of maternal mortality accounted for 24.9 % of all mortalities. As regards the direct causes of maternal mortality, preeclampsia remained the primary cause and represented 27.7 % of the avoidable causes. The second most frequent cause of direct maternal mortality was postpartum hemorrhage (PPH), which represented 26.8 %.Conclusions: Preeclampsia and PPH, as well as their complications are the leading causes of death in one of the biggest tertiary care university hospitals in Egypt. However, there are other important avoidable predisposing factors that should be dealt with including lack of patient education, delayed transfer from other hospitals, and substandard practice.