Retrospective study of maternal mortality in a tertiary hospital in Egypt

BACKGROUND: Making efforts to decrease maternal mortality rate is a moral, economic and human rights related issue. This issue could not be handled without investigation of maternal mortality related factors. The role of anesthesia in maternal mortality in developing countries is obscure. The aim of the study is to estimate the prevalence, causes and risk factors of maternal mortality related to anesthesia. PATIENTS AND METHODS: An observational retrospective study was carried out in our university hospital from January 2004 till December 2008. RESULTS: The study revealed that maternal mean age of death was 34.9 years, 59% of women came from rural areas and 41% from urban ones, 65% delivered inside the hospital while 35% delivered outside, 71% were multiparous, 65% had no antenatal care and 29.7% irregular one, 12% were complaining of concomitant diseases, 77.5% labored with cesarean section, 17% died before labor, 36% during and 47% after labor. Causes of death are given in the order of the most leading cause of death to the least as follows: postpartum hemorrhage, eclampsia, pre-eclampsia, postpartum eclampsia, ruptured uterus, amniotic fluid embolism, accidental hemorrhage, anesthesia and at last unexplained causes. CONCLUSIONS: Maternal mortality was 953 per 100,000 cases and the greatest number of deaths took place among women considered to be at low risk. Anesthesia was responsible for about 8% of the causes of death. Difficult airway management during general anesthesia was the major anesthetic reason for maternal mortality.