Maternal mortality at the Maternity Teaching Hospital in Erbil, Kurdistan: A hospital-based data 2011-2013

* Maternity Teaching Hospital, Erbil, Iraq. ** Head and supervisor of gynecology department of kurdistan board for Medical Specialist. Department of gynecology, College of medicine, Hawler Medical University, Erbil, Iraq. Introduction Maternal mortality data reflect the health care status of any given country in general and the efficiency of health care to women in particular. Maternal mortality is defined by the World Health Organization (WHO) as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. Direct maternal deaths are those resulting from obstetric complications of the pregnant state (pregnancy, delivery and postpartum), interventions, omissions, incorrect treatment, or a chain of events resulting from any of the above. Deaths due to, for example, obstetric hemorrhage or hypertensive disorders in pregnancy, or those due to complications of anesthesia or cesarean section are classified as direct maternal deaths. Indirect maternal deaths are those resulting from previously existing diseases, or from diseases that develop during pregnancy and that are not due to direct obstetric causes but aggravated by physiological effects of pregnancy. For example, deaths due to aggravation of an existing cardiac or renal disease are considered indirect maternal deaths. Approximately 500,000 to 1 million women die each year worldwide because of pregnancy complications. The vast majority of these deaths occur in developing Background and objective: Maternal deaths are still leading problems in many developing countries, including Iraq. Iraq is, in fact, far away to reach the Millennium Development Goal declared to reduce the maternal mortality ratio by three quarters between 1990 and 2015. The aim of this study was to highlight the main causes of avoidable deaths that lead to maternal mortality among those admitted to Maternity Teaching Hospital in Erbil. Methods: This survey was carried out in the Maternity Teaching Hospital in Erbil city, Kurdistan region, Iraq. Variables included in this study were those related to patient’s age, number of parity and mode of delivery of the last baby. Data were collected from patient’s records. In addition, some clinical data were included related to causes leading to death and underlying condition of death. Results: Of the total 75000 live birth recorded in the hospital during the study period (2011-2013), 33 maternal deaths were recorded which gives an overall maternal mortality ratio of 44 per 100,000 live births. Pre-eclampsia and eclampsia were among the top causes of maternal deaths in this study (42.4%) followed by obstetrical bleeding and rapture uterus (30.3%). Conclusion: Maternal mortality rate in Maternity Teaching Hospital was 44/100,000 total live births. The main cause of the maternal deaths was pre-eclampsia and its complications. Most of those died were residents of rural areas and were illiterate women.