Tuesday, April 28, 2009

Mortality

In four hours, we will be attending a Quarterly Morbidity and Mortality Conference of the POGS or Philippine Obstetrical and Gynecological Society - Cebu Chapter. The census for the accredited hospitals in Cebu will be presented as well as one chosen mortality case. This time, it will be our case that will be presented.

You may ask, "What's so significant about that?" In medicine, death is a fact of life. That may be so in most specialties. In GYN, yes, especially if it involves cancer. It's different in OB, though. Aside from the fact that you are taking care of two patients at the same time, most maternal deaths are preventable.

As of 2004, maternal mortality was 107.1 per 100,000 live births with the NCR and Central Visayas having the most number of reported deaths. Largest number of deaths also occurred in the 30-39 y.o. age group (41.1%) and most were due to complications of labor and delivery (34.3%).
Source: National Statistics Office (http://www.census.gov.ph/data/sectordata/sr08320tx.html)

It has been a point of pride in our institution that we have a low maternal mortality, usually only 0-1/year. In the 1st quarter of 2009 alone, we have already had two deaths. This saddens me so much. The first death was due to complications of abortion who came to us already in refractory sepsis and the second was due to postpartum hemorrhage, the patient was delivered at a lying-in center and referred to us too late.

Indeed, death is a reality that we, medical professionals must learn to face and accept. Easier said than done. The death of a loved one is always hard but it helps if we know that the dying one has lived life fully and is ready to face the Maker. What of the mother who died leaving behind her child? What of the young wife who died leaving behind her husband? What of the teen-ager who died because of complications of an induced abortion?

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