Abstract
Background: Covid-19 pandemic affected maternal health directly by causing respiratory disease in pregnant women as well as indirectly by affecting health care delivery and caused sharp increase in maternal mortality. Aim: This study aimed to assess causes and contributing factors for maternal mortality during six months of Covid-19 lockdown. Methodology: This was a retrospective review of all maternal mortalities over the period of six months (23rd March – 22nd September 2020) after implementation of lockdown. Information regarding demographic variables, obstetric characteristics, referral, diagnosis, cause of death and any delay present were obtained from the patient records. The data were analyzed using SPSS 11.5 and descriptive statistics was used. Results: There were 19 maternal deaths, of which one was due to accidental cause. The MMR was 419 per 100,000 live births. Mean age was 29.16 ± 9.53 years with age ranging from 16 to 49 years, 44.4% women never had antenatal check-up, mean POG at presentation was 29.7 ± 9.7 weeks. Four patients died during early pregnancy (two (11.1%) due to abortion related complications and two molar pregnancies) and six (33.3%) expired during antenatal period. Three most common causes for maternal mortality were sepsis (27.8%), hypertensive disorder (22.2%) and obstetric hemorrhage (16.7%). Covid pneumonia caused one (5.6%) mortality. Main contributory cause was anemia (50%). Major delay was in providing appropriate care timely. Conclusion: Maternal mortality was very high during lockdown and the leading cause was sepsis contributed by anemia in most cases. Delays in screening high-risk pregnancies as well as delay in appropriate treatment were responsible factors.
Key words: Contributing factors, Covid-19, maternal mortality