Which of the following is the most common cause of maternal mortality?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022

Obstetrics & Gynaecology

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022

Explanation

Hemorrhage is the leading direct cause of maternal mortality globally, accounting for approximately a quarter of all such deaths.
The majority of fatal hemorrhages occur during the postpartum period (Postpartum Hemorrhage - PPH), often due to uterine atony.
Data from both worldwide and specific national surveys (like in India, where it accounts for up to 38% of maternal deaths) consistently rank hemorrhage as the number one cause.
Its rapid progression to hypovolemic shock makes it particularly dangerous without immediate and skilled intervention.

Option B: Anemia is a major indirect cause of maternal death and a significant contributing factor, but it is not the leading direct cause. It exacerbates blood loss from hemorrhage, but hemorrhage is the primary event.
Option C: Complications from unsafe abortions are a significant cause of maternal mortality (around 8-13% globally), but the number of deaths is lower than those from hemorrhage.
Option D: Sepsis (puerperal infection) is the second or third leading direct cause of maternal death, accounting for about 11-15% of the total. While a major killer, it is less frequent than hemorrhage.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Leading causes of maternal mortality as background academic context rather than a clinical decision trigger.
The nurse's role is critical in preventing death from hemorrhage through the Active Management of the Third Stage of Labor (AMTSL), which includes administering uterotonics, controlled cord traction, and uterine massage.
Nurses must be skilled in rapidly assessing for signs of postpartum hemorrhage (e.g., a boggy uterus, soaking more than one pad per hour, changes in vital signs) and initiating emergency protocols.
What if? If a patient has severe anemia (low hemoglobin) before delivery, her ability to tolerate even a normal amount of blood loss is severely compromised. This increases her risk of death from hemorrhage, emphasizing the importance of treating anemia during the antenatal period.

How to Approach the Question

First, identify the core of the question: it's asking for the 'most common' cause of 'maternal mortality'. This is a factual recall question based on epidemiological data.
Scan the options: Hemorrhage, Anemia, Abortion, Sepsis. All are known causes of maternal death.
Recall the hierarchy of causes. The major direct causes are often taught as the 'big five': hemorrhage, sepsis, hypertensive disorders, obstructed labor, and unsafe abortion.
Differentiate between direct and indirect causes. Anemia is primarily an indirect cause that worsens other conditions.
Compare the prevalence of the direct causes. Consistently, global health data identifies hemorrhage as the single largest cause of maternal deaths.
Therefore, select Hemorrhage as the correct answer.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 2 — Subpart A (pp 1-232 of 464) pp. 57-59, 59-61