Old premise on maternal death at tertiary referral hospital in surabaya, indonesia: Too old, too little, too late

Maternal death is the death of woman during pregnancy, labor, and 42 days postpartum. This study aimed to analyze maternal death at Dr. Soetomo General Hospital, Surabaya in 2019. This was a retrospective study from medical records, weekly reports, audit maternal perinatal death, and morning reports. The data were classified according to maternal, obstetrics, cause of death, and referral characteristics. There were 81 maternal deaths. There were 39% of subjects over 35 years old. Mostly, the subjects were multiparous (76%). Forty-three percent had less than 2 days length of stay, all of them were non-booked case patients, 60% were with direct cause, 80% were hypertensive disease-related, 13% were bleeding, and 8% had indirect cause of heart disease in pregnancy, mostly preventable. Less than two days death were significantly higher in proportion of preeclampsia, postpartum hemorrhagic (PPH) and heart disease in pregnancy (HDiP), reduced GCS, dyspnea, and acidosis not for distant factor (Surabaya vs Non-Surabaya) and preventability. Higher proportions of mothers were aged over 35 years old, multiparous, having direct cause and mostly less than 2 days of length of stay.