July 2019 · Volume 8 · Issue 7 Page 2851 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Thangavelu R et al. Int J Reprod Contracept Obstet Gynecol. 2019 Jul;8(7):2851-2855 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Original Research Article Towards safe motherhood to - are we moving in the right direction?: experience from an urban health facility in South India Ramya Thangavelu, Lalitha Natarajan* INTRODUCTION In the year 2000, the United Nations adopted the Millennium Development Goals (MDG) out of which MDG 5 was targeted on reducing the Maternal Mortality Ratio (MMR) by three fourths between 1999-2015. 1 By the year 2015, Sustainable Development Goals (SDG) were introduced and SDG 3 aimed at Good Health and Well-Being. 2 Under this, the aim is to bring down the global maternal mortality to below 70 per 100000 by the year 2030. At an MMR of 130 per 100,000 live births in 2016,India is ranked 128 in the world. 3,4 WHO commended India for its groundbreaking progress in reducing maternal mortality by 77% to the present rate. 3 Strategies responsible for this achievement include (i) Increased coverage of maternal health services and promoting institutional deliveries (ii) Incentives and financial support for women delivering in the public health system (iii) Improving literacy among women and increasing the average age at marriage (iv) promotion of public-private partnerships in the care of pregnant women. 3 ABSTRACT Background: This study was designed to evaluate the institutional Maternal Mortality Ratio (iMMR) in our institution, a tertiary private medical college hospital and to suggest recommendations and possible interventions to reduce it. Methods: This retrospective descriptive study was conducted by reviewing the hospital records over a period of ten years from January 2009-December 2018. The case records were reviewed for maternal demographic characteristics and complications. Results: The total number of deaths during the study period was 21, giving an iMMR of 85.268 per 100000 live births. Most of the maternal deaths (>80%) occurred postpartum. Obstetric causes contributed to 57% of the deaths with hypertension and hemorrhage topping the list. Other causes were sepsis and non obstetric causes including one case of maternal suicide. 52.38% of the women died more than 48 hours after admission to the hospital, while 28.57% succumbed in less than six hours. Secondary complications noted were ICU admission, extended intubation, massive transfusion, operative intervention and multi organ dysfunction. Conclusions: The classical triad of Hypertension, Hemorrhage and Sepsis continues to be the major determinant of maternal mortality and are potentially preventable by promoting universal access to quality health care, strengthening of health services and ensuring accountability. Keywords: Hemorrhage, Hypertension, Maternal mortality, MMR, Multi organ dysfunction, Suicide Department of Obstetrics and Gynecology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India Received: 11 June 2019 Accepted: 19 June 2019 *Correspondence: Dr. Lalitha Natarajan, E-mail: lalithanatarajan@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20193054