الفهرس 
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Abstract
Maternal mortality in Egypt is still relatively high so measuring maternal mortality and identifying its causes is essential and should be calculated regularly for the purpose of planning, monitoring and evaluation of provided maternal health care.
Maternal mortality is defined as death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes this can be either direct or indirect maternal death.
Recently avoidable maternal mortalities have been summarized in what is called a three –delay framework:
Delay 1; delay in deciding to seek care by the women and /or her family Delay 2; delay in reaching an adequate health facility.
Delay 3; delay in reaching an adequate health facility
Our study aimed at Identification of the different barriers that women face in achieving the timely and effective medical care needed to prevent maternal mortality aiming to improve the obstetric care and thus reduce maternal mortality.
Identifying the circumstances and causes of maternal mortality.
Patients and methods: Twenty cases of maternal mortality occurred during the duration of study from October 2017 to October 2019 in sohag university hospital. Collection of data including age, state of patient, complications, ICU admission and cause of deaths
Results : In our study the most frequent one was the 1st delay that occurred in 10 women followed by 2nd delay in 4 women then combination of 1st and third in about 3 women and combination of 1st and 2nd in 2 cases and delay 2 in 1 case. In our study, Preeclampsia and postpartum hemorrhage are still the most two leading causes of death in developing countries. Moreover, there were two major contributing factors in these deaths: the substandard care and delayed transfer of cases; both are avoidable.
Conclusion: This study showed that the first delay is the most important delay in Sohag, especially in rural areas, and the most important cause of death was pre-eclampsia and ignorance about its complications which was due to lack of antenatal care.
Efforts should be made to ensure that all deliveries occur with the help of skilled personnel
Recommendations
We recommend application of three delay model on large scale in Sohag Governorate to clarify more weakness points. And focusing on antenatal care program.
Also, we recommend increasing facilities to educate mothers in rural areas as medical awareness campaigns, and surveys to pregnant women for early discover preeclampsia or other diseases.
Measuring maternal mortality &identifying its causes should be calculated regularly for the planning, monitoring and evaluation maternal health care.
Improve communication and link with other specialties for cases that require multi-specialist management.
Revising the indication for caesarean section to avoid unnecessary sections because our study revealed that 80% of the maternal death were associated with C.S.
Facilitating delivery of health promotion information in the community so that women and their partners can identify warning symptoms and when they need to access different levels of maternal health services. we provide family planning information so women can better space their pregnancies &have control over the number of children they have.
Providing support to upgrade health center buildings and medical equipment and medicine.