A one year review of eclampsia in an Ethiopian Tertiary Care Center (Saint Paul’s Hospital Millennium Medical College, SPHMMC)

2017 ◽  
Vol 45 (7) ◽  
Author(s):  
Thomas Mekuria ◽  
Abdulfetah Abdosh
Keyword(s):  
Developing Countries ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Magnesium Sulphate ◽  
Arrival Time ◽  
Care Center ◽  
Tertiary Care ◽  
Case Fatality ◽  
Developed Countries ◽  
Health Facilities

AbstractEclampsia remains one of the five major causes of maternal mortality in developing countries. Advances in diagnosis and management have led to a significant reduction in maternal mortality and morbidity from this disease in developed countries. In developing countries the incidence of maternal death attributed to eclampsia remains high and, in Ethiopia, maternal mortality from this complication has instead risen over the last decade. The purpose of this study was to review the incidence of eclampsia at the largest feto-maternal center in the country over 1 year in an attempt to determine what quality improvement measures are needed and could realistically be implemented within the system to decrease this complication. There were a total of 104 eclamptic patients during the study period. The hospital incidence of eclampsia was 82/10,000 deliveries excluding those arriving to the hospital in the postpartum period (28 cases). There were eight maternal deaths making the case fatality rate one in 13 cases. The median convulsion to arrival time, referral to arrival time and magnesium sulphate administration time were found to be 3, 2 and 3 h, respectively. The probability of multiple seizures (≥3 episodes) was increased significantly with the prolongation of these time variables. Occurrence of multiple seizures was in turn significantly associated with adverse maternal outcomes (ICU admission, morbidities and mortalities). As expected, there was a high incidence of eclampsia and eclampsia related maternal death in the hospital. We recommend a thorough assessment of the referral system, upgrading and capacity building of more health facilities, organizing trainings and drills in health facilities; and availing magnesium sulphate in all health centers among others.

scholarly journals Analysis of causes of maternal mortality in tertiary care center, 11 years study

2021 ◽  
Vol 10 (9) ◽  
pp. 3320
Author(s):  
Vandana R. Saravade ◽  
Munira Ansari ◽  
Ganesh Shinde
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Care Center ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Hepatitis Infection ◽  
Mortality Ratio ◽  
Late Referral ◽  
Timely Treatment

Background: Objectives to study the causes of maternal mortality and the complications leading to maternal death.Methods: A retrospective study of hospital records and death summaries of all maternal death over a period of 11 years from January 2008 to December 2018 was carried out at tertiary care hospital, Mumbai.Results: There were a total of 459 maternal death out of 36930 live birth giving maternal mortality rate mean maternal mortality ratio (MMR) of 1242 per 100000 live births. Unregistered and late referral account for maternal death. The majority of women were in 21-30 years age group in 20 to less than 37 weeks of pregnancy. The commonest cause of death was due to hepatitis infection 129 (28.1%), sepsis 52 (11.32%), PIH including eclampsia 46 (10.02%), cardiovascular diseases 33 (7.18%), haemorrhage 31 (6.75%), Kochs 31 (6.75%) and respiratory diseases 22 (4.79%).Conclusions: Maternal mortality can be reduced by identifying causes which are preventable and giving timely treatment.

scholarly journals A study of efficacy and feasibility of laparoscopic surgery in a tertiary care center, Pokhara, Nepal

2021 ◽  
Vol 14 (2) ◽  
pp. 141-145
Author(s):  
Anuj Shrestha ◽  
Sunil Man Bijukchhe ◽  
Anand Bhattarai ◽  
Bhojraj Neupane ◽  
Ketki Kaushal
Keyword(s):  
Developing Countries ◽  
Laparoscopic Surgery ◽  
Complication Rate ◽  
Conversion Rate ◽  
Care Center ◽  
Tertiary Care ◽  
Operation Time ◽  
Developed Countries ◽  
Cross Sectional ◽  
Operative Complication

Introduction: Laparoscopic surgery is the gold standard technique for most of the gastrointestinal surgeries in developed countries. However, challenges in developing countries, apart from cost of instrumentation, include lack of awareness. Therefore, the aim of this study is to determine the efficacy and feasibility of laparoscopic surgeries in our part of the world. Methods: Retrospective, cross-sectional study was carried out from January 1, 2018 to June 30, 2019. Patient’s information on demographic details, type of laparoscopic surgery, operation time, length of hospital stay, reasons for conversion to open surgery, and intra-operative and post-operative complication details were retrieved from the operation log book and patient’s chart. Results: A total of 380 patients that underwent laparoscopic surgeries were included in the study. Out of 193 patients that underwent laparoscopic cholecystectomy, there were 144 (74.61%) females and 49 (25.38%) males with conversion rate of 4.66% and post-operative complication rate of 8.80%. Similarly, among 136 patients that underwent laparoscopic appendectomy, there were 68 (50%) females and 68 (50%) males with conversion rate of 4.41% and post-operative complication rate of 14.70%. Finally, amid 51 patients who underwent trans-abdominal pre-peritoneal approach, post-operative seroma collection was seen in three cases and port site hematoma formation was seen in two cases only. Conclusions: Our results were comparable with various literature demonstrating that laparoscopic surgeries are safe and effective. However, evolution of laparoscopic surgery in developing countries is still slow. Therefore, effective training and availability of required instruments is needed.  

scholarly journals Hypertension in Pregnancy Still Remains a Serious Complication Causing Severe Morbidity and Mortality of Mother

2016 ◽  
Vol 30 (2) ◽  
pp. 92-97
Author(s):  
Arife Simsek ◽  
Seyfettin Uludag ◽  
Ali Benian ◽  
Abdullah Tuten
Keyword(s):  
Maternal Mortality ◽  
Care Center ◽  
Tertiary Care ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Deaths ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Mortality Index ◽  
Retrospective Examination

Objective(s): The aim of this study is to evaluate frequency and nature of maternal deaths and maternal near-miss cases in a tertiary care hospital.Materials and Methods: A retrospective examination was conducted on records of the16.612 women who delivered in a tertiary care center, over a ten-year period (1997-2006). The flow chart recommended by Say et al was used in the analysis of the maternal near-miss cases.Results: The ratios of mortality related with pregnancy, maternal mortality and maternal nearmiss were 68.11/100.000, 61.29/100.000 and 17.09/1000, respectively. The ratio of maternal near- miss to maternal mortality was 27.8 and the mortality index was 3.46%. Hypertensive disorders were the leading cause of maternal deaths and maternal near-miss events.Conclusion: Hypertensive disorders were still leading cause of maternal deaths and maternal near-miss events.Absence of antenatal care and disrupted referral chains were major problems.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 92-97

scholarly journals Maternal mortality-a three-year retrospective study in a rural medical college of India

2021 ◽  
Vol 10 (8) ◽  
pp. 3019
Author(s):  
Jayasree Hansda ◽  
Debobroto Roy ◽  
Krishnapada Das ◽  
Manojit Sarkar ◽  
Rumpa Das ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Tertiary Care Centre ◽  
Maternal Deaths ◽  
Demographic Profiles ◽  
Medical College ◽  
Mortality Ratio ◽  
Tragic Event

Background: Maternal mortality is a tragic event as family revolves around a mother. The deadly obstetrical triad of hemorrhage, preeclampsia and infection has accounted for a third of all deaths. This study was conducted to assess maternal mortality ratio, demographic profile and causes of maternal death.Methods: This retrospective longitudinal study was conducted in the department of obstetrics and gynecology for a period of three years from 1st January 2018-31st December, 2020. Total no of death during this period was 134.Records of deaths and demographic profiles were retrieved from the medical record library of aforesaid hospital.Results: There were 134 maternal deaths amongst 56815 live births with MMR 235.85. The majority of deaths were in 20-29 year of age group and most of the deaths seen in multigravida. The 91.79% death was observed within the 24 hours and after 72 hours. Eclampsia, preeclampsia and hemorrhage were leading cause of maternal death seen in the study.Conclusions: Maternal mortality is higher than national MMR. Majority of maternal death were preventable by proper antenatal care, early detection of high-risk pregnancies and their timely referral to tertiary care centre.

scholarly journals Trends and causes of maternal mortality in a tertiary care hospital over five years: 2013-2017

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Sonia Rafiq ◽  
Wajeeha Syed ◽  
Simi Fayaz Ghaffar
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Creative Commons ◽  
Increased Risk ◽  
Mortality Ratio ◽  
Public Health Challenge

Background and Objective: Maternal death measurement is essential to a country’s wellbeing and development status. In emerging countries like Pakistan, it remains an intimidating and failed public health challenge. Objectives of our audit were to estimate trends and causes of maternal demise in Lady Reading Hospital, Peshawar, Pakistan. Methods: Between January 2013 to December 2017, a retrospective study was carried out at Medical Teaching Institute, Lady Reading Hospital, Peshawar. A structured proforma was used to collect data from the medical records. To detect trends in mother demise maternal mortality ratio was calculated for each year and for all five years, Spss version 23 was used for data analysis. Results: In the five-year periods 134 deaths were recorded. The maternal mortality during the study period was 431/100,000 live births. An unstable trend in mortality with two crowning periods in 2013 and 2017 was observed. Hemorrhage persisted as the foremost cause of maternal death over the five years period, accounting for 47.76% deaths followed by hypertension, accounting for 25.37% deaths. An increased risk of 35.08% was observed among women aged 25-29 years, followed by 26.11% in 20-24 years and 23.88% in >30 years. Conclusion: There is a decreasing trend of maternal death from 2013 to 2016 but a slight increase was noted in 2017. Hemorrhage was the top cause responsible for the maternal death. doi: https://doi.org/10.12669/pjms.35.4.1091 How to cite this:Rafiq S, Syed W, Ghaffar SF. Trends and causes of maternal mortality in a tertiary care hospital over five years: 2013-2017. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.1091 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Maternal Mortality in 19th- and Early 20th-century Italy

2019 ◽  
Vol 33 (3) ◽  
pp. 860-880 ◽  
Author(s):  
Matteo Manfredini ◽  
Marco Breschi ◽  
Alessio Fornasin ◽  
Stanislao Mazzoni ◽  
Sergio De lasio ◽  
...  
Keyword(s):  
Developing Countries ◽  
Maternal Mortality ◽  
Systematic Study ◽  
Developed Countries ◽  
Living Standards ◽  
Early 20Th Century ◽  
Peculiar Characteristic ◽  
Micro Level ◽  
The Impact ◽  
Over Time

Summary Although dramatically reduced in Western and developed countries, maternal mortality is still today one of the most relevant social and health scourges in developing countries. This is the reason why high levels of maternal mortality are always interpreted as a sign of low living standards, ignorance, poverty and woman discrimination. Maternal mortality represents, therefore, a very peculiar characteristic of demographic systems of ancien regime. Despite this important role in demographic systems, no systematic study has been addressed to investigate the impact of maternal mortality in historical Italy. The aim of this article is to shed some light on such a phenomenon by investigating its trend over time and the determinants in some Italian populations between the 18th and the early 20th centuries. The analysis will make use of civil and parish registers linked together by means of nominative techniques, and it will be, therefore, carried out at the micro level.

scholarly journals Study of cases of post-partum hemorrhage after spontaneous vaginal delivery in labour room of obstetrics and gynecology department of tertiary care center, Ranchi, Jharkhand, India

2020 ◽  
Vol 9 (4) ◽  
pp. 1540
Author(s):  
Bratati Moitra ◽  
Bulllu Priya Oraon
Keyword(s):  
Blood Loss ◽  
Vaginal Delivery ◽  
Maternal Death ◽  
Post Partum ◽  
Care Center ◽  
Tertiary Care ◽  
Spontaneous Vaginal Delivery ◽  
Lower Middle Class ◽  
Threatening Condition ◽  
Labour Room

Background: Postpartum haemorrhage is one of the common causes of maternal death worldwide. Whenever the amount of blood loss from or into genital tract is 500 ml or more after delivery of baby or any amount of bleeding that makes patients haemodynamically unstable is post-partum haemorrhage.Methods: In this study amount of blood loss after spontaneous vaginal delivery was measured in 100 cases by calibrated blood drape. Patients having high risk criteria for PPH were excluded.Results: In this study 55% patients were from 20-30 years age group. 82% cases were nontribal. 94% belonged to lower middle class. 67% patients were primigravida. 89% patients had atonic PPH and 11% had traumatic PPH. 85% patients had mild PPH. 60% of atonic PPH was managed by oxytocin only. 10% required oxytocin + Methergin, 6% required oxytocin + Methergin + Misoprostol. 6% required Oxytocin + Methergin + Misoprostol + Carboprost. In this study surgical intervention was required in 18% cases. Blood transfusion was required in 74% cases. 75% cases were from non-tribal ethnicity.Conclusions: PPH is a life-threatening condition. If it can be diagnosed early and managed properly then many maternal lives can be saved. In this study there was no maternal death.

scholarly journals Estimation of the Burden of Pandemic(H1N1)2009 in Developing Countries: Experience from a Tertiary Care Center in South India

PLoS ONE ◽  
2012 ◽  
Vol 7 (9) ◽  
pp. e41507 ◽  
Author(s):  
Mahesh Moorthy ◽  
Prasanna Samuel ◽  
John Victor Peter ◽  
Saranya Vijayakumar ◽  
Dipika Sekhar ◽  
...  
Keyword(s):  
Developing Countries ◽  
South India ◽  
Care Center ◽  
Tertiary Care ◽  
Pandemic H1n1 ◽  
Tertiary Care Center ◽  
Pandemic H1n1 2009

scholarly journals Maternal mortality review by three delay model: a retrospective study from a tertiary care hospital of Chhattisgarh

2020 ◽  
Vol 10 (1) ◽  
pp. 262
Author(s):  
Sangeeta R. Jogi ◽  
Anju R. Ekka
Keyword(s):  
Retrospective Study ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Individual Case ◽  
Postnatal Period ◽  
Care Hospital ◽  
Delay Model ◽  
Health Seeking ◽  
Very High

Background: SDG 3 includes an ambitious target of reducing the global MMR to less than 70 per 100 000 births by 2030. In order for effective initiation of measures to reduce maternal mortality it is necessary to assess the levels of delays, causes of death, health seeking behavior during antenatal and postnatal period and obstacles in reception of health services.Methods: Retrospective study of 112 maternal death cases from a tertiary medical centre (Medical College) was done. The details of all the maternal mortalities from January 2018 to July 2020 were collected from the individual case sheets, facility-based maternal death review form and MDR Case Summary.Results: The study reported a very high MMR of 802. Hypertensive disorders (36.61%), Obstetric haemorrhage (25.89%) and Sepsis (14.29%) constituted the major direct cause of maternal deaths whereas anaemia was the most common indirect cause (7.14%). First, second and third delays were present in 95.54%, 70.54% and 47.32% cases respectively.Conclusions: Suboptimal ANC, long distances to reach final hospitals, high number of referrals and admission during complicated stage explains the very high maternal mortality in the present study. Application of Three Delay Model revealed that most of the maternal death occurred due to delays in multiple levels and first delay was the most commonly identified delay. Accelerated efforts should be implemented to minimize all the delays in order to achieve SDG goals.

scholarly journals Update: Primary immunodeficiency disorders among north Indian children

2021 ◽  
Vol 8 (4) ◽  
pp. 465-472
Author(s):  
Rakesh Kumar Deepak ◽  
Prabin Kumar ◽  
Abhinav Saurabh ◽  
Narendra Bagri ◽  
Sonia Verma
Keyword(s):  
Developing Countries ◽  
Primary Immunodeficiency ◽  
Tertiary Care ◽  
Developed Countries ◽  
North India ◽  
Indian Children ◽  
Primary Immunodeficiency Disorders ◽  
Medical Practitioners ◽  
History Of ◽  
The Developed Countries

Primary immunodeficiency disorders (PIDs) are a group of genetic abnormalities characterized by defectin one or more constituents of the immune system.This group of disorders are largely undiagnosed and unreported worldwide due to lack of awareness among the medical practitioners,parents as well as lack of state of art diagnostic facilities. Earlier we had reported the distribution pattern of various categories of PID in children of north India; in this report we are appending the data with current findings.In this retrospective study we pooled data from PIDs workup of 706 children with suspected PIDs, below the age of 18Yrs, in the period of May 2017 October 2019. The clinical assessment and presentation of these children was suggestive of PID. The peripheral blood of these children was used for flow cytometry based immunophenotyping of immune cells. PIDs were classified according to the International Union of Immunological Societies’ (IUIS) criteria.A total of 133 (18.38%) children were diagnosed with one or other form of PID with overall median age was 3.25 years (male: 2.3 and female: 4.2Yrs). Chronic infection, persistent diarrhea and retarded growth were the common warning signsin these patients. Combined humoral and cellular immunodeficiency was observed in 32%, phagocytic defect in 23%, antibody defect in 17%, dysregulated innate immunity in 19% and other well defined syndromes in 9% of total diagnosed PID children. Around 15.78% of PID cases were seen in coupleswithconsanguineous marriage, past family history of PID in 20.30% and families with sibling death of unknown cause in 24.06%. The cause of death of the sibling was not known. PID diagnosed children received prophylactic antibiotics and/or antifungals in addition tospecific therapy for the underlying immune deficiency.The field of PID remainsunexplored worldwide. The awareness in the developed countries is more than that of developing countries like India. The developing countries face several challenges in the diagnosis of PIDs such as awareness among patients and medical practitioners, mostly in the rural settings, lack of sufficient number of tertiary care centres, lack of equipped immunological laboratory to diagnose the disease.

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