Maternal Mortality: 19-Year Experience in an Eastern North Carolina Tertiary Center
Objective: To examine the cases and causes of maternal mortality at a tertiary care center in eastern North Carolina and to identify risk factors associated with maternal deaths.
Design: A retrospective study of hospital records, death certificates, and autopsy reports was done on all obstetrical deaths from 1988 through 2006 at Pitt County Memorial Hospital (PCMH).
Results: Fourteen maternal deaths were identified during this period. Nine deaths were direct maternal deaths, and five were indirect. Nine of the deaths were potentially preventable through proper preconceptional counseling, early identification, and treatment of diseases such as preeclampsia and premature rupture of membranes. The limitations to this study include lack of detail regarding the prenatal care and nonavailability of autopsy reports for several of the patients.
Conclusion: Preconceptional counseling, to educate patients on pregnancy risk and self identification of preeclampsia, prompt medical diagnosis and treatment of preeclampsia and premature rupture of membranes (PROM), and quick transfers to level II or III hospitals with appropriate specialists to care for these patients could reduce maternal mortality in this region. Finally, the risk factors that increase the area’s maternal mortality include its rural location, its low socioeconomic status, and the high number of African-American and single women.
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