Maternal death at Dr. Soetomo general hospital surabaya – Indonesia according to McCarthy and Maine’s model 2013-2015

Background: Surabaya contributes to the highest maternal mortality rate in East Java Province, Indonesia. Maternal deaths can be prevented by quality antenatal examinations and by identifying patients. This research was conducted to analyze maternal mortality in the year 2013-2015 at Dr. Soetomo Hospital according to McCarthy-Maine’s model. Material and Methods: This was a retrospective study conducted in a tertiary referral hospital by taking data from medical records of maternal deaths for two years. Results: There were 180 maternal deaths in 3 years: 71 women in 2013, 56 women in 2014 and 53 in 2015, 25% more than 35 years old, 5.5% under 20 years old, all were non booked-cases. Referred cases was mostly from other hospitals, residency: 64.4% from outside Surabaya municipal town. The direct causes were: hypertensive disease in pregnancy (28.8%), postpartum hemorrhage (11.1%), and sepsis (21.6%); The indirect causes were heart disease in pregnancy (17.7%) and others; gestational age was 53.3% before 34 weeks. Mostly, the deaths occurred less than 48 hours (42.7%) after admission. There was also a tendency that the number maternal death and proportion of hypertensive disease decreased but vice versa for postpartum hemorrhage in three years Conclusion: Intermediate determinants are main factors in maternal death.