Prevalence and Patterns of Severe Maternal Morbidity beyond Maternal Mortality at PIMS Hospital Islamabad

Objective: To determine the prevalence and patterns of severe maternal morbidity among women delivering at Pakistan Institute of Medical Sciences Hospital, Islamabad. Study Design: Retrospective descriptive cross-sectional studyPlace and Duration of Study: This study was conducted at the MCH Unit II, Department of Obstetrics and Gynecology, Pakistan Institute of Medical Sciences from Jan-2021 to Dec-2022. Methods: The records of all women who delivered at the hospital during the study period were included. This medical record was reviewed retrospectively to identify cases of severe maternal morbidity based on major clinical conditions such as obstetric hemorrhage, hypertensive disorders of pregnancy, sepsis, cardiac and hepatic dysfunctions, or other life-threatening complications. Descriptive statistics were employed to present the frequency and patterns of severe maternal morbidity among the study participants. Results: Out of a total 9158 deliveries, severe maternal morbidity was found in 886 women (excluding cases of maternal death) giving a prevalence of 9.7%. The mean age of affected women was 29.4 ± 5.8 years with 58.7% belonging to urban residential status and only 39.3 % were booked cases. Analysis of the patterns revealed that major obstetric hemorrhage was the leading cause of severe maternal morbidity (50.0%), followed by hypertensive disorders of pregnancy (23.7%), sepsis (7%) and anemia (3.6%). Conclusion: Severe maternal morbidity is a significant public health challenge at tertiary care level, with obstetric hemorrhage, hypertensive disorders and sepsis as the major contributors to its development. The high proportion of non-booked and poorly booked cases is the area where improvement can be expected through increased access to antenatal care and quality.