Many Maternal Deaths Avoidable Based on Audit in Indonesia

Recently published study of hospital deaths among pregnant women in Indonesia in 2014 reveals that 90% of the deaths were felt to be avoidable.

https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.12736

Maternal death reviews: A retrospective case series of 90 hospital‐based maternal deaths in 11 hospitals in Indonesia

Mohammad Baharuddin Dwirani Amelia Stephanie Suhowatsky Ary Kusuma Mohammad Hud Suhargono Benjamin Eng

First published: 27 February 2019 https://doi.org/10.1002/ijgo.12736 Cited by: 2

Funding Information

United States Agency for International Development (USAID)

Abstract

Objective

To determine the factors contributing to hospital‐based maternal deaths in Indonesia, given most women deliver with skilled birth attendants and in health facilities.

Methods

A retrospective review of case records examined quality of care issues related to maternal mortality in hospital settings. The review abstracted information from blinded medical records of 90 women who died in 11 hospitals from January to June 2014. Specialists from the Indonesian Society of Obstetrics and Gynecology reviewed abstracted records to determine causes of death and identify contextual factors for these deaths.

Results

Seventy‐five of the 90 maternal deaths (83%) reviewed were due to direct obstetric causes. Severe pre‐eclampsia and eclampsia combined were the leading direct cause of death (42%). Human resource/health worker factors were more frequently identified than supply, facility, or infrastructure factors. Ninety percent of maternal deaths were classified as preventable.

Conclusion

The review exercise yielded useful information on factors contributing to preventable maternal mortality in hospitals in Indonesia. Results helped focus quality improvement efforts and increased awareness of the value of routine, in‐depth facility‐based maternal death reviews.