PATTERN OF SEVERE ACUTE MATERNAL MORBIDITY AT CMH QUETTA

Maternal Morbidity

Abstract

Objectives; To determine the pattern of severe acute maternal morbidity (SAMM) at Combined Military Hospital Quetta.
Study design; Descriptive Study.
Place and Duration of study; Department of Gynae Obs, Combined Military Hospital Quetta from March 07 to Sept 08.
Patients and Methods; One hundred admitted patients of severe acute maternal morbidity (SAMM) were identified through random sampling procedure. Thorough history, examination and laboratory investigation were considered to identify the pattern of SAMM that is; severe hemorrhage, hypertension, sepsis, pulmonary embolism, uterine rupture, inversion, ruptured ectopic pregnancy etc and to recognize patient features common in cases of SAMM like maternal age, parity, socio-economic/ educational status and level of antenatal care.
Results; Out of 100 patients of SAMM, 52% had severe obstetrical hemorrhage, 32% had hypertension, 10% had both severe pre-eclampsia and massive obstetrical hemorrhage, 4% had ruptured Ectopic pregnancies, 1% had septic induced abortion and 1(1%) had puerperal sepsis. These complications were greater in booked multi-gravidas of 20 to 40 years, para 3 to 5, under matric and with less than Rs.10,000/month income.
Conclusion; Massive Hemorrhage and uncontrolled hypertension are the major contributors of severe acute maternal morbidity. SAMM is more prevalent in women of 20 to 30 years (reproductive age), parity 3-5, under metric and with monthly income of less than Rs.10,000.