INDIRECT CAUSES OF MATERNAL DEATH- AN AUTOPSY STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 38
Abstract
BACKGROUND Autopsy is an important tool in the investigation of maternal death. It provides valuable information about pathophysiological changes in various organs, which may be important in the delineation of the sequence of events leading to maternal death. The present study was conducted at Department of Forensic Medicine at Government Medical College, Thiruvananthapuram, Kerala during 1995 January to April 2003. The circumstances which lead to medico-legal autopsy were cases either brought dead to casualty, referred cases due to obstetrical complications from distant hospitals and allegations of medical negligence in the care and management by relatives which later turned into a medico-legal case. The objectives of the study are: 1. To detect the spectrum of causes leading to maternal death cases subjected to medico-legal autopsy. 2. To identify the indirect, late and fortuitous causes of maternal deaths. 3. To suggest measures to prevent maternal deaths. MATERIALS AND METHODS Sixty-five cases brought for medico-legal autopsy during the period from January 1995 to April 2003 were included in the present retrospective/ prospective study. RESULTS In the present study, direct maternal deaths were the leading cause in 39 cases (60%), among them postpartum haemorrhage was the prime cause of death i.e. 15 cases (23%), 24 cases (37%) were due to indirect causes and 2 cases (3%) were fortuitous deaths. Even though death following obstetric haemorrhage remained the prime direct cause, indirect causes of maternal deaths were valvular heart disease, intracranial pathology, hepatic and pulmonary disease complicating pregnancy. CONCLUSION A detailed autopsy examination supplemented with all necessary investigations can reveal many obscure causes, as it was found in the present autopsy study. A multidisciplinary approach with regular audit and mortality conferences on maternal deaths will help to identify the causes and to prevent maternal deaths. Though the risk of death from complications of pregnancy has decreased during the past few decades in India, it continues to remain higher in other developing countries.
Authors and Affiliations
Zachariah Thomas
Keywords
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- EP ID EP548109
- DOI 10.14260/jemds/2018/946
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