Maternal Death: Audit in a Tertiary Hospital.

Maternal death audit in a tertiary hospital was conducted to improve the quality of maternal health care. In this descriptive type cross sectional study, maternal deaths were reviewed and factors responsible for maternal death were identified and noted in Rajshahi Medical College Hospital from July 2008 to June 2009. During the study period total 63 maternal deaths recorded among 7560 deliveries. Almost 43% deceased mother was less than 25 years of age. 39.7% mother died during their first pregnancy. Among the delivery group 46% cases delivered vaginally. Regarding time interval 33.3% of death occurred within six hours of admission to hospital. The main causes of death were eclampsia (46%), PPH (17.5%), septic abortion (12.7%). One or more Institutional factors were identified and among them lack of obstetric ICU facility was related to73% cases. Delayed or lack of blood transfusion was responsible for 46% cases and delayed attendance by senior doctors were related to 30% cases. Substantial number of maternal death occurred at or <25 years of age. Eclampsia, hemorrhage, septic abortions along with substandard care was identified as the major cause of maternal death.