Abstract
Objective: evaluation of direct and indirect causes of maternal deaths in a tertiary care hospital.
Materials and methods: All maternal deaths of woman aged 15-45 that occurred during a one year period 2011 at Sheikh Zaid women Hospital Larkana were reviewed prospectively and stratified by age, socioeconomic status, availability and utilization of health care services during pregnancy and at time of delivery, and referrals. Percentages were calculated for both direct and indirect causes of maternal deaths, 3 delays, time from admission to death, and for preventability.
Results: An MMR of 14.9 was calculated. 82% of the mothers were in mid twenties to mid thirties, 44% were grand multipara, and 22% primigravida and 60% did not receive any antenatal care. The most common direct causes (64%) of death were PPH 20%, Pre-eclampsia 18%, and APH 12%, while peripartum cardiomyopathy 14%, Hepatic encephalopathy 12%, and Pulmonary embolism 6%, and only 30% women have received medical treatment for them.
Conclusion: Nearly 15% women died and majority were young. PPH, APH and eclampsia were the commonest causes of death. Only one third women received medical treatment. (Rawal Med J 2013;38: ).

Key words: Maternal mortality, MMR, eclampsia, postpartum hemorrhage.