MATERNAL DEATHS FROM OBSTETRIC HAEMORRHAGE: THE ROLE OF INDICATORS LATE MATERNAL MORTALITY

2015 ◽  
Vol 0 (2) ◽  
pp. 139
Author(s):  
Olga Vasilievna Tutynina ◽  
Antonina Timofeevna Yegorova ◽  
Natalia Vladimirovna Zhirova
Keyword(s):  
Maternal Mortality ◽  
Maternal Deaths ◽  
Obstetric Haemorrhage

scholarly journals Progress towards the Ending Preventable Maternal Mortality (EPMM) target for Bangladesh: The role of female education

2020 ◽  
Author(s):  
Karar Zunaid Ahsan ◽  
Peter Kim Streatfield ◽  
Kanta Jamil ◽  
Shams El Arifeen
Keyword(s):  
Maternal Mortality ◽  
Health Sector ◽  
Mortality Data ◽  
Female Education ◽  
Maternal Deaths ◽  
Education Levels ◽  
Education Status ◽  
Nationally Representative ◽  
Mortality Survey

AbstractEducational attainment among women is a well-recognized predictor for maternal mortality. Data from nationally representative surveys and the United Nations are used in the analysis for estimating maternal mortality due to improved education status up to 2030. Analysis of data from 2001 and 2010 Bangladesh Maternal Mortality Survey shows that MMR varies considerably by education level. The study shows that during 2011–2030, 15% maternal deaths will be averted due to fertility change (i.e. fewer births) and 24% of the maternal deaths can be averted only by improving the female education levels. However, in order to achieve the Ending Preventable Maternal Mortality (EPMM) target of 59 maternal deaths per 100,000 live births by 2030 for Bangladesh, a further 64% reduction will be required. Factors outside the health sector, like female education, will continue to have an impact maternal mortality in Bangladesh. However, reaching the EPMM target for Bangladesh by 2030 will also require significant investments in maternal health programs, in particular those to increase access to and quality of services.

scholarly journals Obstetric Haemorrhage Related Maternal Mortality: A Two-Year Experience at a Teaching Hospital in Bangladesh

2021 ◽  
Vol 8 (2) ◽  
pp. 90-94
Author(s):  
Tahmina Ahmed ◽  
Nazmul Haque ◽  
Bithi Debnath ◽  
Samsunnahar Begum
Keyword(s):  
Maternal Mortality ◽  
Economic Condition ◽  
Haemorrhagic Shock ◽  
Obstetric Hemorrhage ◽  
College Hospital ◽  
Maternal Deaths ◽  
Medical College ◽  
Obstetric Haemorrhage ◽  
Rupture Of Uterus ◽  
The Common

Background: Bangladesh is one of the developing countries where the maternal mortality is extraordinarily high. Objectives: This study was conducted to find out the number and cause of obstetric haemorrhage related maternal death. Methodology: This retrospective study was conducted in the department of obstetrics & gynaecology at M.A.G Osmani Medical College Hospital, Sylhet, Bangladesh from January 2006 to December 2007. From all maternal deaths related to pregnancy occurred in that period, only death due to obstetric hemorrhage were enrolled. Thereafter, the records of hemorrhage related death patients were scrutinized and data were collected from death register. All necessary information was collected in a pre-designed clinical data sheet and analyzed. Results: Among all deaths in obstetric unit, maternal mortality due to obstetric haemorrhage was 32.09%. The deaths were common among multipara (3-4) in 26-30 years age group. Most of them were from lower socio-economic condition having no or irregular antenatal checkup. Among the causes of obstetric haemorrhage, PPH was the commonest. Atonic uterus was the main cause of PPH. Injudicious use of oxytocin and obstructed labour were the common cause of rupture of uterus. Although the causes of haemorrhage were different, most of the patients died due to haemorrhagic shock. Conclusion: This study helps to detect the magnitude of problem and major causes of maternal deaths specially haemorrhage related maternal deaths. Journal of Current and Advance Medical Research, July 2021;8(2):90-94

A Community-Based Investigation of Maternal Mortality from Obstetric Haemorrhage in Rural Zimbabwe

1997 ◽  
Vol 27 (3) ◽  
pp. 159-163 ◽  
Author(s):  
S Fawcus ◽  
M Mbizvo ◽  
G Lindmark ◽  
L Nyström ◽  
Keyword(s):  
Maternal Mortality ◽  
Traditional Birth Attendant ◽  
Community Based ◽  
Maternal Deaths ◽  
High Risk Factors ◽  
Obstetric Haemorrhage ◽  
Emergency Transport ◽  
High Age ◽  
Service Factors ◽  
Ruptured Uterus

In the rural province Masvingo in Zimbabwe, 25% of maternal deaths were caused by obstetric haemorrhage, which had a cause specific maternal mortality rate (MMR) of 40 per 100 000 live births. Forty per cent of cases were due to a ruptured uterus, and 30% to an atonic uterus. Forty-two per cent were more than 35 years old and 44% para 5 or more. In spite of antenatal coverage for 85% of the women, 42% died outside any health facility. Fifty per cent of the women had had no intervention whatsoever before death from haemorrhage. The most important factor for prevention at community level is provision of emergency transport, which would have saved 50% of the women. Other non-health service factors contributing to the adverse outcome were found in actions of the patient herself or a traditional birth attendant. In the health services avoidable factors were identified in 58% of women. More effective antenatal attention to high risk factors, especially high age and parity, appropriate use of maternity waiting shelters, action programmes for management and haemorrhage at all levels, basic resources for resuscitation, improved surgical skills with supervision and available transport for referrals are all necessary parts of a programme to prevent maternal deaths from obstetric haemorrhage.

scholarly journals Classification of maternal mortality by ICD-MM: a retrospective study from a tertiary care hospital of Chhattisgarh

2021 ◽  
Vol 10 (2) ◽  
pp. 492
Author(s):  
Anju R. Ekka ◽  
Sangeeta R. Jogi
Keyword(s):  
Retrospective Study ◽  
Maternal Mortality ◽  
Cause Of Death ◽  
Maternal Death ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Targeted Interventions ◽  
Hypertensive Disorders ◽  
Obstetric Haemorrhage

Background: Sustainable development goal 3 (SDG 3) includes an ambitious target of reducing the global maternal mortality rate (MMR) to less than 70 per 100 000 births by 2030. To reach this target, countries need an accurate picture of the levels and causes of maternal deaths. A standardization of the cause of death attribution will improve interpretation of data on maternal mortality, analysis on the causes of maternal death, and allocation of resources and programmes intended to address maternal mortality. International classification of diseases-maternal mortality (ICD-MM) has proven to be easily applicable and helps clarify the cause of maternal death.Methods: Retrospective study of 142 maternal death cases was done in a tertiary medical centre (medical college) from December 2017 to November 2020 for determining the causes of maternal death and their classification according to ICD-MM.Results: Direct causes of maternal deaths were observed in 82.39% cases whereas indirect causes were present in remaining 17.61% cases. Hypertensive disorders (35.92%), obstetric haemorrhage (26.06%) and pregnancy related infection (14.79%) constituted the major groups of direct cause of maternal deaths whereas anaemia was the most common indirect cause (7.75%).Conclusions: Hypertensive disorders (35.92%), obstetric haemorrhage (26.06%) and pregnancy related infection (14.79%) were the major causes of direct obstetric death and anaemia (7.75%) was the most common cause of indirect obstetric death. All of these causes are preventable with targeted interventions. Reducing maternal mortality is one of the key targets within the SDG and ICD-MM is a valuable tool for uniform and standard classification of maternal deaths as well as for developing strategies for reducing maternal death. Training on cause of death certification, maternal death surveillance and response (MDSR) documentation and use of ICD is essential to enable consistent application of ICD coding and improve data collection and analysis.

Pelaksanaan Program Perencanaan Persalinan Dan Pencegahan Komplikasi (P4K) Melalui Peran Keluarga

2019 ◽  
Vol 18 (2) ◽  
pp. 49-58
Author(s):  
Yusriani Yusriani ◽  
Muh. Said Mukharrim ◽  
Reza Aril Ahri
Keyword(s):  
Public Health ◽  
Maternal Mortality ◽  
Health Center ◽  
Sampling Technique ◽  
Maternal Deaths ◽  
Live Births ◽  
South Sulawesi ◽  
Work Area ◽  
The Family

The maternal mortality rate (MMR) is one of the important indicators of public health. AKI describes the number of women who die from a cause of death related to pregnancy disorders or treatment (excluding accident or incidental cases) during pregnancy, childbirth and during the puerperium (42 days after delivery) regardless of the length of pregnancy per 100,000 live births. South Sulawesi Province is one of the regions experiencing high maternal mortality problems, especially in Gowa Regency, namely in 2018 as many as 17 cases of maternal deaths, the highest cases of which were in the work area of Somba Opu Health Center, namely 5 cases. The general objective of this study is to analyze the role of the family in implementing the P4K program. The design of this study was qualitative with descriptive explanative design using purposive sampling technique with 33 informants consisting of 6 pregnant women, 4 husbands, 5 posyandu cadres, 3 village midwives, 1 coordinator midwife puskesmas, 8 heads environment and 6 village heads. The role of the family in implementing the P4K program in the work area of Somba Opu Health Center in Gowa Regency has been carried out but not optimally, there are still some indicators that have not been fulfilled.

scholarly journals Applying the WHO ICD-MM classification system to maternal deaths in a tertiary hospital in Nigeria: A retrospective analysis from 2014–2018

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244984
Author(s):  
Godwin O. Akaba ◽  
Obiageli E. Nnodu ◽  
Nessa Ryan ◽  
Emmanuel Peprah ◽  
Teddy E. Agida ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Classification System ◽  
Maternal Mortality Ratio ◽  
Evidence Based ◽  
Continuous Variables ◽  
Maternal Deaths ◽  
Hypertensive Disorders ◽  
Obstetric Haemorrhage ◽  
Mortality Ratio ◽  
Underlying Causes

Background Addressing the problem of maternal mortality in Nigeria requires proper identification of maternal deaths and their underlying causes in order to focus evidence-based interventions to decrease mortality and avert morbidity. Objectives The objective of the study was to classify maternal deaths that occurred at a Nigerian teaching hospital using the WHO International Classification of Diseases Maternal mortality (ICD-MM) tool. Methods This was a retrospective observational study of all maternal deaths that occurred in a tertiary Nigerian hospital from 1st January 2014 to 31st December,2018. The WHO ICD-MM classification system for maternal deaths was used to classify the type, group, and specific underlying cause of identified maternal deaths. Descriptive analysis was performed using Statistical Package for Social Sciences (SPSS). Categorical and continuous variables were summarized respectively as proportions and means (standard deviations). Results The institutional maternal mortality ratio was 831/100,000 live births. Maternal deaths occurred mainly amongst women aged 25–34 years;30(57.7%), without formal education; 22(42.3%), married;47(90.4%), unbooked;24(46.2%) and have delivered at least twice;34(65.4%). The leading causes of maternal death were hypertensive disorders in pregnancy, childbirth, and the puerperium (36.5%), obstetric haemorrhage (30.8%), and pregnancy related infections (17.3%). Application of the WHO ICD-MM resulted in reclassification of underlying cause for 3.8% of maternal deaths. Postpartum renal failure (25.0%), postpartum coagulation defects (17.3%) and puerperal sepsis (15.4%) were the leading final causes of death. Among maternal deaths, type 1, 2, and 3 delays were seen in 30(66.7%), 22(48.9%), and 6(13.3%), respectively. Conclusion Our institutional maternal mortality ratio remains high. Hypertensive disorders during pregnancy, childbirth, and the puerperium and obstetric haemorrhage are the leading causes of maternal deaths. Implementation of evidence-based interventions both at the hospital and community levels may help in tackling the identified underlying causes of maternal mortality in Nigeria.

scholarly journals Trends on Maternal Mortality in the Republic of Benin and Comparison with the Neighboring Countries

2020 ◽  
Vol 13 (2) ◽  
pp. 197-216
Author(s):  
Romeo Konnon ◽  
Said Semyatov ◽  
Muhammednazar Soyunov ◽  
Zalina Sokhova ◽  
Tatevik Zulumyan
Keyword(s):  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
High Rate ◽  
Maternal Deaths ◽  
Live Births ◽  
Obstetric Haemorrhage ◽  
Mortality Ratio ◽  
Republic Of Benin ◽  
The Republic ◽  
The Government

The maternal mortality ratio in the Republic of Benin in 2015 was still high – 405 per 100,000 live births. The delay in consultation and timely treatment, unavailability of medical facilities and lack of skilled care are the principal factors contributing to maternal deaths in Benin. Consequently, the rate of such preventable causes of maternal deaths like obstetric haemorrhage (38.40 percent and pre-eclampsia/eclampsia (14.30 percent) remains high in the country, and even HIV continued being one of the indirect causes of maternal deaths in 2017 – one percent. High rate of complications associated with pregnancy and birth in adolescent girls is another cause of maternal deaths in the Republic of Benin. Despite the efforts of the Government aimed at improving health care, it is unlikely that we will achieve the United Nations Sustainable Development Goals 3.1. – the reduction of maternal mortality ratio to less than 70 per 100,000 live births by 2030.

scholarly journals An investigation of maternal mortality at a tertiary hospital of the Limpopo province of South Africa

2017 ◽  
Vol 32 (2) ◽  
pp. 73-76
Author(s):  
Sam T. Ntuli ◽  
Mabina Mogale ◽  
Francis L.M. Hyera ◽  
Shan Naidoo
Keyword(s):  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Tertiary Hospital ◽  
Limpopo Province ◽  
Hospital Death ◽  
Maternal Deaths ◽  
Live Births ◽  
Obstetric Haemorrhage ◽  
District Hospitals ◽  
Mortality Ratio

Objective: To understand the elements influencing the maternal deaths in the Limpopo province, South Africa.Methods: A retrospective review of all maternal deaths which occurred at the Pietersburg Hospital, Limpopo province was done over a five-year period (January 2011 to December 2015). The hospital death register was used to collate a list of maternal deaths occurring during the study period. The medical records of maternal deaths were reviewed. The total deliveries and live births for each year were obtained from the delivery registers. The data collected included maternal age, parity, referring facility, date of admission, date and time of death, ward where death occurred, and cause of death.Results: There were 14 685 live births and 232 maternal deaths between 2011 and 2015, resulting in an institutional Maternal Mortality Ratio (iMMR) of 1579/100 000 live births. The mean age of the patients was 29 years. Forty-three per cent of deaths occurred within 24 hours of admission, 35% died in ICU and 89% were referred from regional and district hospitals and community health centres. Of the referred patients, 83% were from district hospitals. Obstetric haemorrhage and pre-eclampsia, or eclampsia, were the main causes of death.Conclusion: The iMMR at Pietersburg Hospital remains unacceptably high. Most of the maternal deaths are due to obstetric haemorrhage, pre-eclampsia or eclampsia, medical and surgical disorder and non-pregnancy related infections.

scholarly journals The power of marginal gains in obstetric anaesthesia

2020 ◽  
pp. 176-182
Author(s):  
DN Lucas ◽  
A Ezihe-Ejiofor ◽  
MC Mushambi
Keyword(s):  
Maternal Mortality ◽  
Pathological Condition ◽  
Valuable Insight ◽  
Maternal Deaths ◽  
Middle Income ◽  
Obstetric Anaesthesia ◽  
Middle Income Countries ◽  
The Usa ◽  
Underlying Causes

The crucial role of anaesthesia in improving outcomes in obstetrics has received renewed attention over the last few years. In 2016, Sobhy and colleagues presented the first systematic review of anaesthesia-related maternal mortality in lowincome and middle-income countries (LMICs).1 They found that anaesthesia contributed to 2.8% of all maternal deaths in LMICs. This is a relatively small percentage and may be superficially reassuring to anaesthesia providers; however, the overall frequency of anaesthesia-related maternal death was 300-fold higher for neuraxial anaesthesia and 900-fold higher for general anaesthesia than that reported for the USA.2 In contrast to other causes of maternal mortality, anaesthesia does not represent a disease or pathological condition; deaths related to anaesthesia are iatrogenic. The underlying causes of death in the study by Sobhy and colleagues included airway-related complications (45%), pulmonary aspiration (31%) and staff competencies and equipment issues (27%). It therefore behoves all anaesthesia providers who care for obstetric patients to scrutinise practice and seek ways to reduce anaesthesia-related morbidity and mortality. This edition of SAJAA features four articles of direct relevance to obstetric anaesthesia that provide valuable insight into aspects of care and strategies for quality improvement.

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