Maternal Mortality Yet to Be Minimized

Abstract The changes in the causes of maternal deaths in a major referral hospital over a span of 39 years from 1945 to 1983 have been reviewed. There were 235,319 deliveries and 118 maternal deaths. The overall maternal mortality rate per 100,000 total births was 50. The rate declined from 89 during the period 1945 to 1954 to 10 in the last decade. There has been a significant decline in direct maternal deaths from infection, haemorrhage and preeclampsia–eclampsia since the first half of the studied period. Pulmonary embolism and general anaesthesia were not found to be an important cause of maternal death. Heart disease and amniotic fluid embolism were the two major causes of maternal death in the last 19 years. During the past 9 years non‐obstetric causes have almost approached direct causes of maternal death in frequency. Continued vigilance is still needed to eliminate death resulting from haemorrhage, infection and preeclampsia–eclampsia. Risk of maternal death due to other causes can be minimized only if a greater effort is made to identify the at‐risk patients particularly those with medical disorders so that an adequate pre‐conceptional advise and a multi‐disciplinary approach to the patient care can be provided.