The Ratio of Severe Maternal Outcome and its Related Factors in an Academic Hospital from October 2019 to October 2020

Based on the Millennium Development Goals, the maternal mortality rate should be reduced by two-thirds of 2010 until 2030 (in Iran below 10 per 100,000 live births). Since it is necessary to identify the risk factors of death and survive the near death mothers, this study was performed with aim to evaluate the ratio of severe maternal outcome and its related factors.

This cross-sectional study was performed in an academic hospital of Mashhad in 2019-2020. Pregnant women and women who in the first 42 days after delivery (puerperium) suffered from a severe complication but survived, and also cases that led to maternal death entered the study by census method. Using a checklist of the Ministry of Health organization, demographic data, risk factors, pregnancy complications, outcome of complications, vital interventions and ICU admission and outcomes of pregnancy and mother were extracted from the patient's file.

During one year, severe maternal outcome ratio was 50.26 per 1000 live births and near death mothers ratio was 45.60 per 1000 live births. The most common risk factors were hypertension (22%) and bleeding in the current pregnancy (19%), and the most common life-threatening complications were severe bleeding during pregnancy and postpartum (32%), and severe preeclampsia (22%). The most common critical intervention used was ICU admission (62%) and blood/blood products transfusion (37%). The most common organ failure was respiratory disorders (29%) and coagulopathy (20%). The most common cause of death was COVID-19 (30%).

Hypertension and bleeding are the most important risk factors during pregnancy and the most important life-threatening complications in cases of near death mothers. With proper prevention and treatment measures and education of mothers and medical team, the mortality due to these complications can be reduced.