The most frequent cause of maternal death during childbirth is?

VSSC Nursing Officer - 2021

Obstetrics & Gynaecology

Easy

Appeared in: VSSC Nursing Officer - 2021

Explanation

Hemorrhage is the single most frequent cause of maternal death during childbirth worldwide and in India.
Data from India's Sample Registration System (SRS) survey shows hemorrhage accounts for 38% of all maternal deaths, making it the leading cause.
The most common type is postpartum hemorrhage (PPH), often resulting from uterine atony, where the uterus fails to contract effectively after delivery, leading to uncontrolled bleeding from the placental site.

Option A: Sepsis, a severe bloodstream infection, is a significant cause of maternal mortality, but it is not the most frequent. It accounts for approximately 11% of maternal deaths.
Option B: Toxemia, which encompasses hypertensive disorders of pregnancy like pre-eclampsia and eclampsia, is a major cause of maternal death but is less common than hemorrhage, accounting for about 5% of deaths.
Option C: Asphyxia refers to a lack of oxygen to the body's tissues. In this context, it applies to the fetus or newborn (perinatal asphyxia) and is a leading cause of neonatal death, not maternal death.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Causes of maternal mortality as background academic context rather than a clinical decision trigger.
Nurses are critical in preventing and managing postpartum hemorrhage (PPH). Key nursing roles include active management of the third stage of labor (AMTSL), which involves administering uterotonics, controlled cord traction, and uterine massage.
Rapid identification of excessive bleeding and prompt initiation of PPH protocols are life-saving nursing interventions. This includes fundal massage, ensuring patent IV access for fluids and medications, and escalating care immediately.
What if? If a patient has known risk factors for PPH (e.g., a twin pregnancy, prolonged labor, or a previous PPH), the nurse should proactively ensure that blood products are cross-matched and readily available, and maintain a heightened state of vigilance for signs of excessive bleeding.

How to Approach the Question

This is a factual recall question that tests your knowledge of maternal health statistics.
First, identify the core components of the question: 'most frequent cause' and 'maternal death during childbirth'.
Recall the primary direct causes of maternal mortality: hemorrhage, sepsis, hypertensive disorders, obstructed labor, and unsafe abortion.
Compare the relative frequencies of these causes. Epidemiological data consistently shows that hemorrhage is the leading cause globally and in India.
Evaluate the options. Eliminate 'Asphyxia' as it pertains to the newborn, not the mother.
Between Hemorrhage, Sepsis, and Toxemia, select Hemorrhage as it is statistically the most common cause.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 2 — Subpart A (pp 1-232 of 464) p. 59-61

E6 Obstetrics Williams p. 47-65