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Abstract Maternal death is defined as death of any woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of pregnancy, from any cause related to or aggravated by the pregnancy. The maternal mortality rate is defined as the number of maternal deaths per 100,000 women of the reproductive age (14-49), while the maternal mortality ratio is the number of maternal deaths per100.000 live births. The causes of maternal deaths should be divided into two groups: Direct obstetric deaths are those resulting from obstetric complications. Indirect obstetric deaths are those resulting from previous existing disease or disease that developed during pregnancy and aggravated by physiologic effects of pregnancy (e.g., cardiac disease, psychiatric illness, hepatic disease). In Egypt, maternal mortality in spite the recent progresses continues to be one of the existing and pressing problems. Incorrect or absent diagnosis of causes of death, elevated percent of literacy, poverty, and deliveries conducted at places rather than equipped hospitals has made the accurate measurement of the problem difficult. Despite of the previous difficulties, Egypt is on the right track in terms of reducing maternal mortality rates according to many indicators issued by the Ministry of Health, where the national maternal mortality ratio in year 1990 was nearly 233, and the ratio is decreasing year after year, to 130 in year 2000, then 84in year 2005, to 45 in year 2010, to become 37 in year 2017. Summary 66 This retrospective study conducted at Menoufia Governorate about maternal mortality in the period from 1/1/2015 to 31/12/2019, had revealed (186) maternal deaths, the total live births within the five years were (524121). Maternal mortality cases were distributed on the five years of the study period as follow; 21 cases in 2019, 40 cases in 2018, 48 cases in 2017, 42 cases in 2016, and 35 cases in 2015. The cases presenting with hemorrhage represented 51.6 % of the total maternal death cases ranked the 1st causative factor. The cases presenting with hypertensive disorders of pregnancy represented 24.1 % of the total maternal deaths which ranked the 2nd cause of death. Sepsis and infections ranked the 3rd common cause of death in this study, which accounted for 11.8% from total deaths Heart diseases ranked the 4th common cause of death in this study, which accounted for 5.9% from total deaths. Other medical diseases represented in total 2.6%. 7cases were presented post trauma, representing 3.8% of all maternal deaths. However, for improving maternal heath, four essential elements should be done: Adequate primary health care at all levels, and an adequate share of the available food for girls from infancy to adolescence, and family planning universally available, to avoid unwanted or high risk pregnancies. Summary 67 After pregnancy begins, good prenatal care, including nutrition with efficient and early detection and referral of high risk patient. The assistance of a trained person for all women in child birth, at home or in the hospital. Women at higher risk must all have effective access to the essential elements of obstetric care. This retrospective study on maternal mortality cases in the period from January 2015 to December 2019 revealed that: 1. Efficient and fast transfer of the pregnant ladies to the delivery unites to provide the medical services to them in proper time. 2. Providing of enough blood units and its substitutes to manage hemorrhagic cases properly. 3. Presence of recent and efficient system for patient registration; this will ensure:- First: Recall the patient’s data with easly way from archivies. Second: Registering the patients’ data, their medications, and medical services provided to them, to estimate the medical services later on when needed 4. The importance of provision of ICU inside the hospital, as they are considered the last resource for critically ill and dangerous cases. 5. Training of junior doctors on the different labor stages and dealing with dangerous cases, together with the basics of the science of obstetrics. |