Maternal mortality and its relationship to Emergency Obstetric Care (EmOC) in a tertiary care hospital in South India

Background: HIV is prevalent in epidemic proportions in India. Identifying the target population and effective intervention reduces chances of vertical transmission and new infection. Authors studied the seroprevalence of HIV among women attending obstetric care in a tertiary care hospital of South India and associated maternal and perinatal outcomes among seropositive women.Methods: Retrospective descriptive study of all women who were screened for HIV at Integrated Counselling and Testing Centre, Vani Vilas hospital, from January 2014 to December 2017 in their antenatal, intranatal and postnatal period. Demographic data of seropositive women, obstetric outcomes and status of children at 18months were obtained.Results: Of the 35,455 women who were screened, 0.28% were found positive for HIV. Percentage prevalence of HIV was highest in 2014 (0.32%). Majority of the seroprevalence belonged to age group of 25-29 years (44%), 32% illiterates, 82% homemakers and 79% belonged to urban areas. Unknown partner status in 22% and majority were diagnosed in antenatal period (66%). Of them 82% had favourable CD4 count. 74 % of them delivered live baby. Three maternal deaths were observed and anaemia (65%) was the major associated co-morbidity. Vaginal route was common mode of delivery (84%). Thirteen babies required NICU admission and 6 neonates deaths were encountered. Exclusive breastfeeding was practised in 91% of live births. 62% of children were found seronegative at 18 months follow up.Conclusions: Authors observed with adequate treatment to mother and prophylaxis to the baby, the burden of vertical transmission can be significantly reduced.

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Study of maternal mortality in a tertiary care hospital in a tribal KBK area of Odisha, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201217 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1528

Author(s):

Sasmita Behuria ◽

Jyoti Narayan Puhan ◽

Subhra Ghosh ◽

Bhabani Sankar Nayak

Keyword(s):

Maternal Mortality ◽

Tertiary Care Hospital ◽

Physiological State ◽

Tertiary Care ◽

Obstetric Care ◽

Safe Motherhood ◽

Care Hospital ◽

Maternal Deaths ◽

Live Births ◽

Hypertensive Disorders In Pregnancy

Background: Pregnancy, although being considered a physiological state, carries risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labor, or thereafter. The major causes of maternal mortality are mostly preventable through regular antenatal check-up, proper diagnosis, and management of labor complications. Therefore, the factors at different levels affecting the use of these services need to be clearly understood. The aim is to study the incidence of MMR, assess the epidemiological aspects, causes of maternal mortality and avoidable factors that can prevent maternal deaths.Methods: A retrospective hospital-based study was conducted in obstetrics and gynecology department, SLN MCH, a tertiary care referral hospital in a tribal area of southern Odisha over a period of 2 years from April 2017 to March 2019.Results: A total of 108 deaths were analyzed over 2 years period and MMR was calculated to be 1124/1 lakh live births. Most of the maternal deaths occurred in the age group of 20-24 years (35.1%), majority of maternal deaths were observed in multipara (46.3%), 70.3% deaths occurred within 24 hours of admission. Hypertensive disorders in pregnancy (37%) were the leading direct cause followed by hemorrhage (14.8%) and sepsis (11.1%). Among the indirect causes jaundice (7.4%) and anaemia (3.7%) were the leading cause.Conclusions: MMR in our study was very high as compared to national average of 167/1,00,000 live births, being a tertiary care hospital as most of the patients were referred from peripheral centers. Most maternal deaths are preventable by intensive health education, basic obstetric care for all, strengthening referral and communication system and emphasizing on overall safe motherhood.

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Maternal mortality and its relationship to emergency obstetric care (EmOC) in a tertiary care hospital in South India

Obstetric Medicine ◽

10.1177/1753495x15575949 ◽

2015 ◽

Vol 8 (2) ◽

pp. 86-91 ◽

Cited By ~ 1

Author(s):

Papa Dasari

Keyword(s):

Maternal Mortality ◽

Cause Of Death ◽

Tertiary Care ◽

Maternal Mortality Ratio ◽

Emergency Obstetric Care ◽

Obstetric Care ◽

Care Hospital ◽

Maternal Deaths ◽

Emergency Admissions ◽

Mortality Ratio

Objective: To determine the trends in maternal mortality ratio over 5 years at JIPMER Hospital and to find out the proportion of maternal deaths in relation to emergency admissions. Methods: A retrospective analysis of maternal deaths from 2008 to 2012 with respect to type of admission, referral and ICU care and cause of death according to WHO classification of maternal deaths. Results: Of the 104 maternal deaths 90% were emergency admissions and 59% of them were referrals. Thirty two percent of them died within 24 hours of admission. Forty four percent could be admitted to ICU and few patients could not get ICU bed. The trend in cause of death was increasing proportion of indirect causes from 2008 to 2012. Conclusion: The trend in MMR was increasing proportion of indirect deaths. Ninety percent of maternal deaths were emergency admissions with complications requiring ICU care. Hence comprehensive EmOC facilities should incorporate Obstetric ICU care.

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Maternal Mortality in an Urban Tertiary Care Hospital of South India

Indian Journal of Obstetrics and Gynecology Research ◽

10.5958/2394-2754.2016.00007.2 ◽

2016 ◽

Vol 3 (1) ◽

pp. 32 ◽

Cited By ~ 1

Author(s):

Rajeswari ◽

Shobha

Keyword(s):

Maternal Mortality ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital

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Maternal mortality in a tertiary care hospital: a 3-year retrospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210006 ◽

2021 ◽

Author(s):

Harish K. M. ◽

Shwetha N. ◽

Nalini N.

Keyword(s):

Retrospective Study ◽

Maternal Mortality ◽

Low Socioeconomic Status ◽

Tertiary Care ◽

Maternal Mortality Ratio ◽

Emergency Obstetric Care ◽

Obstetric Care ◽

Epidemiological Data ◽

Care Hospital ◽

Contributing Factors

Background: Systematic review to determine the epidemiological aspects and causes of maternal mortality there by exploring possibility of intervention and implementing Evidence-based health policies and programmes to prevent future maternal death. Aims and objectives of the study were to calculate the maternal mortality rate in our hospital, to assess the epidemiological aspects of maternal mortality, to assess the type of delay and causes of maternal mortality and to suggest ways to reduce the MMR.Methods: This is a 3-year retrospective study from Jan 2017 to Dec 2019 that will be conducted in the department of obstetrics and gynaecology, The Apollo medical college and District hospital, Chittoor a tertiary care teaching hospital situated in the southernmost part of Andhra Pradesh state in India. It gets a large number of referrals from PHCs, CHCs, and maternity homes as well as from hospitals across Chittoor district. Epidemiological data will be collected from the hospital register. Maternal mortality ratio, epidemiological factors and causes affecting maternal mortality are assessed.Results: MMR in present study was 66 per 1,00,000 live births. Women in the age group of 20 to 30 years (85.72%), illiteracy (57.16%) and low socioeconomic status (100%) were risk factors for maternal mortality. Obstetric haemorrhage (57.16%) is most common cause whereas type 1 and type 2 delays are most common contributing factors for maternal mortality.Conclusions: Early identification and management of pregnancy complication, strengthening of existing Emergency obstetric care (EmOC) facilities, easy transport and appropriate referral linkages are keys to reduce maternal mortality to further extent.

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