aternal death refers to death during pregnancy or within 42 days after termination of pregnancy, regardless of the duration and site of the pregnancy, from non-incidental reasons which are aggra- vated by the state or duration of pregnancy. 1 According to the Health Sta- tistics Yearbook (2014), the maternal mortality rate is 15.9 in 100,000 in Turkey and 9 in 100,000 in the western Anatolian region. According to the World Health Statistics, the annual maternal mortality in Turkey has de- clined by 20% between 1990 and 2013, a testament to the healthcare infra- structure of this country. 2 Most maternal deaths are preventable and the statistics of maternal mortality are one of the indicators of socio-economic development of any country. The health system of a country is responsible for investigating the JCOG 2018;28(2):35-43 35 Discussion on Provincial Evaluation Results of Maternal Mortality in Terms of Preventability: Commission Decision Differences in Konya ABSTRACT Objective: The objective of this study was to investigate the risk factors of maternal mortality in Konya province, as well as the preventability of deaths in cases where the central and local commissions differed in their decisions. Material and Methods: Maternal mortality between 2009 and 2014 in the Konya province was screened for the cases, where the central and local Ma- ternal Mortality Investigation Commissions gave different decisions. These differences pertain to whether the deaths were ‘preventable’ or ‘not-preventable’, differences in the first, second and third delay models, and indirect, direct and incidental deaths. The data were evaluated electron- ically along with a descriptive statistical analysis, differences in the decisions and compliance in the mortality rates were evaluated. Results: The median age of the deceased mothers was 28 (21– 44) years and 83.3% of the mothers had at least one mortality risk factor. While the overall ma- ternal mortality rate was 36.7% within the first 48 h after birth, the rates were highest within the first 48 h after birth (26.7%) and between the 1st and 42nd day after birth (26.7%) in indiffer- ently assessed cases. The cause in 30% of all deaths and 33.3% of deaths with differential assess- ments was postpartum hemorrhage, as per the results of central Maternal Mortality Investigation Commissions. The decisions of the central and local commissions differed in terms of preventa- bility, delay models or death classification in 50% of the deaths. Taken together, the compliance between central and local decisions was not precise in investigating maternal mortality. Conclu- sion: The first 48 h after birth and the postpartum period are particularly critical. The causes of death, particularly postpartum hemorrhage, should be thoroughly investigated. We recommend periodic re-evaluations of cases where different decisions were made, in order to lower the rate of preventable maternal mortality. Keywords: Maternal mortality; preventability; Konya Yasemin DURDURAN, a Sema SOYSAL, b Mustafa BAŞARAN, c Çetin ÇELİK, d Ali ACAR, e Canan DOĞAN, f Hüsnü Murat KAYA, f Şule İZGİ, f Hasan ÖZNAVRUZ f Departments of a Public Health, b Medical Education and Informatics, e Obstetrics and Gynecology, Konya Necmettin Erbakan University Meram Faculty of Medicine, c Clinic of Obstetrics and Gynecology, Private Medova Hospital, d Department of Obstetrics and Gynecology, Selçuk University Faculty of Medicine, f Public Health Directorate, Konya Received: 12.10.2017 Received in revised form: 27.03.2018 Accepted: 19.04.2018 Available online: 31.08.2018 Correspondence: Yasemin DURDURAN Konya Necmettin Erbakan University Meram Faculty of Medicine, Department of Public Health, Konya, TURKEY ydurduran@gmail.com Copyright © 2018 by Türkiye Klinikleri DOI: 10.5336/jcog.2017-58388 ORIGINAL RESEARCH