Changing perspectives of infectious causes of maternal mortality

Objective: infections significantly contribute to maternal mortality. there is a perceived change in the spectrum of such infections. this study aims to estimate the contribution of various types of infections to maternal mortality. material and methods: we retrospectively reviewed records of maternal death cases that took place between 2003 and 2012 in the christian medical college,vellore,india. the international classification of diseases-maternal mortality was used to classify the causes of deaths and world health organization near-miss criteria were used to identify organ dysfunction that occurred before death. infections during pregnancy were divided into three groups,i.e.,pregnancy-related infections,pregnancy-unrelated infections,and nosocomial infections. results: in this study,32.53% of maternal deaths were because of some type of infection as the primary cause. the contribution of pregnancyrelated infections was comparable with that of pregnancy-unrelated infections (16.03% vs. 16.50%). metritis with pelvic cellulitis,septic abortions,tuberculosis,malaria,scrub typhus,and h1n1 influenza (influenza a virus subtype) were among the most commonly encountered causes of maternal death due to infections. another 7.07% of cases developed severe systemic infection during the course of illness as nosocomial infection. a significant majority of mothers were below 30 years of age,were primiparae,had advanced gestational age,and had operative delivery. cardiovascular and respiratory system dysfunctions were the most common organ dysfunctions encountered. conclusion: the contribution of pregnancy-unrelated infections to maternal deaths is significant. control of these diverse community-acquired infections holds the key to a reduction in maternal mortality along with the promotion of clean birthing practices. nosocomial infections should not be underestimated as a contributor to maternal mortality. © 2015 by the turkish-german gynecological education and research foundation.