scholarly journals Analysis of maternal mortality: a retrospective study at tertiary care centre

Author(s):  
Surekha N. Khandale ◽  
Kshama Kedar

Background: Mother is the pillar of the family and maternal deaths during pregnancy and delivery are great loss to baby, family, society and country too. Epidemiological data pertaining to maternal mortality is valuable in each set-up to design interventional programs to reduce the ratio favourably. This study was design to evaluate the mortality rate in our hospital, to assess the epidemiological aspects and causes of maternal mortality, types of delay, and to suggest recommendations for improvement. Aim of the study was to analyse the causes of maternal death at tertiary care centre. Objective of the study was to analyse causes of maternal death and type of delay, and to suggest measures to reduce it.Methods: A retrospective study done at a tertiary level care centre from January 2011 to June15. Demographic data and other data were collected from maternal death review forms and case records. Data studied and analysed.Results: Most maternal deaths were due to obstetric causes like eclampsia (16.66%), preeclampsia (11.53%), anaemia (14.10%)and haemorrhage (10.25%). Associated co-morbid medical conditions hepatitis (6.41%) and heart disease (5.12%) were in the top list. Majority women were from rural area (69.23%), belonged to below poverty line (76.92%), had less than three visits (64.09%), received care at periphery below the level of specialist sub-district hospital. 94.87%were referred, and travelled more than 4 hours to reach hospital (88.44%). In majority cases Type 1 delay was most common (85.89%) comparatively to Type 2 and 3 delay.Conclusions: High risk cases should be identified. Early referral, easy transport, continued skill based training, monitoring of health services can reduce maternal mortality. Special training should be conducted for ASHA workers and ANM who generally works at grass root level in our country. Continued medical training is required for medical officers who are working at PHC and sub district hospital for early recognition of high risk women and their referral in time to higher centers to avoid maternal near miss or death.

Author(s):  
Prachi Sarin Sethi ◽  
Sujata Sharma ◽  
Indu Chawla

Background: The World Health Organization (WHO) estimates that, of 536,000 maternal deaths occurring globally each year, 136,000 take places in India. Maternal death has serious implications to the family, the society and the nation. It deprives the surviving infant of mother's care. This study was done to assess maternal mortality in a tertiary care centre in north India where large numbers of patients are referred from the peripheral centers and the rural parts. This study was done to assess the causes of maternal mortality and suggest remedial measures to reduce the same. Objective of present study was to assess the causes of maternal death over a period of one year at G.M.C Amritsar, India.Methods: A retrospective hospital based study of 22 maternal deaths over a period of 1 year from June 2012 to June 2013. The information regarding demographic profile and reproductive parameters were collected and results were analyzed.Results: Over the study period, there were 22 deaths and 7272 live births (Majority were referral from other districts all over Punjab). Most common direct cause of maternal mortality was haemorrhage and anemia was the most common indirect cause. Most maternal deaths were seen in patients from rural areas, unbooked, illiterate patients and patients from low socioeconomic status.Conclusions: Proper health education should be given to the women; early registration of antenatal cases should be done which allows for rapid diagnosis and treatment of high risk cases. Also constructing a well equipped health care facility with trained staff and prompt transport facilities for early referral can bring down the maternal mortality rate in our country.


Author(s):  
Sridevi G. ◽  
Shanmugavadivu L.

Background: Mother is the pillar of the family. Maternal death is a great loss to the baby, family, society and country. Pregnancy although being considered as a physiological state carries risk of serious maternal morbidity and mortality . This is due to various complications that may occur during pregnancy, labour or thereafter. Maternal mortality ratio is a very sensitive index that reflects the quality of healthcare provided by the community to the women population.Methods: A retrospective study of 204 maternal deaths over a period of 56 months from July 2013-february 2018. Demographic data were collected from maternal death review form and records. Data studied and analyzed.Results: During the study period, there were 33968 deliveries and 204 maternal deaths with a MMR of 600.5/1,00,000 live births. Eclampsia was the leading direct cause of death. Anemia was the leading indirect cause of death. Most of the women died within 24 hours of admission suggesting that majority of patients reached the tertiary care hospital quite late. Majority of deaths occurred in the age group of 20-30 years and in postpartum period.Conclusions: Most maternal deaths are preventable by optimal utilization of existing MCH facilities, identifying the bottleneck in health delivery system, early identification of high-risk pregnancy and therein timely referral to tertiary care centre.


Author(s):  
Jayasree Hansda ◽  
Debobroto Roy ◽  
Krishnapada Das ◽  
Manojit Sarkar ◽  
Rumpa Das ◽  
...  

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.


Author(s):  
Nandkishore B. Gaikwad ◽  
Poornima M. ◽  
Reshma M. Lad

Background: Maternal mortality is a vital index of the effectiveness of obstetric services prevailing in a country. The key to progress of a country lies in reducing its maternal morbidity and mortality, hence to give a better assessment of the problem a retrospective study on maternal mortality was carried out. An objective of the study was to find the cause and epidemiological factors for maternal mortality in a tertiary care hospital in western Maharashtra from January 2018 to August 2019.Methods: A retrospective, descriptive study done at tertiary care hospital in western Maharashtra from January 2018 to august 2019. Data was collected from medical records department and the study was conducted by reviewing the records of maternal death and scrutinizing for various aspects likely to be related to maternal death such as age, locality of residence, antenatal care, admission death time interval and cause of death.Results: during the study period 63 maternal deaths occurred and 75302 live births, Maternal Mortality Ratio were 83.66 per 1 lakh live birth. 46% of maternal deaths were in age group of 21-25 years, 87% of patients belonged to rural area, 74% belonged to lower socioeconomic status. 43%  were unregistered patients, 43% had vaginal delivery, 73% had no free transportation, 68% were referred patients, 60% were referred from private hospitals, 48% of maternal death occurred <24 hours, 73% of maternal death were due to direct cause, 28% of maternal deaths were due to pre-eclampsia and its complications, 15.8% due to sepsis and 12.6% due to Postpartum hemorrhage.Conclusions: Being a tertiary care hospital, where patients are referred from periphery maternal mortality was found to be on higher side. Proper implementation of government policies with community participation along with strengthening of First Referral Unit (FRU) and Primary Health Centres can help to reduce maternal mortality.


Author(s):  
Rashmi Kumari ◽  
Usha Kumari ◽  
Krishna Sinha

Aim: prevalence and the various direct and indirect etiologies of maternal mortality. Materials and Methods: The present 1 years retrospective hospital based study was conducted in the Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College and Hospital, Bhagalpur,Bihar,India Results: A total of 56 deaths were analyzed. The mortality rate in study period was 333 per 1,00,000 live births. Maximum maternal deaths (60.7%) were reported in the age group 21-25 years. More deaths were reported in multiparous women (67.9%) as compared to primiparous women (32.1%). Most of them were unbooked cases (60%). Hemorrhage (30.4%), eclampsia (16.1%), sepsis (12.5%) and embolism (7.1%) were the major direct causes of maternal death. Anemia (16.1%) was the major indirect cause of death. Conclusions: Hemorrhage is the leading cause of maternal death followed by hypertensive disorders and sepsis. Anemia continues to be the most common indirect cause. Majority of maternal deaths were preventable by proper antenatal care, early detection of high risk pregnancies and their timely referral to tertiary care centre. Keywords: MMR, Hemorrhage, Sepsis, Anemia


Author(s):  
Sweety Rani ◽  
Abha Rani Sinha

Aim: to assess the existing MMR and the causes of maternal mortality. Materials and Methods: The present retrospective hospital based study was conducted in the Department of Obstetrics and Gynecology, Patna Medical College and Hospital, Patna, Bihar from Jan 2017 to march 2018. Results: A total of 56 deaths were analyzed. The mortality rate in study period was 333 per 1,00,000 live births. Maximum maternal deaths (60.7%) were reported in the age group 21-25 years. More deaths were reported in multiparous women (67.9%) as compared to primiparous women (32.1%). Most of them were unbooked cases (60%). Hemorrhage (30.4%), eclampsia (16.1%), sepsis (12.5%) and embolism (7.1%) were the major direct causes of maternal death. Anemia (16.1%) was the major indirect cause of death. Conclusions: Hemorrhage is the leading cause of maternal death followed by hypertensive disorders and sepsis. Anemia continues to be the most common indirect cause. Majority of maternal deaths were preventable by proper antenatal care, early detection of high risk pregnancies and their timely referral to tertiary care centre. Keywords: MMR, Hemorrhage, Sepsis, Anemia


Author(s):  
Hemalatha S. V. ◽  
Manickadevi M. S.

Background: The aim of the study was to analyse the causes of maternal mortality at a tertiary care centre and find measures to reduce it.Methods: A retrospective study of maternal deaths from January 2018 to December 2020 that occurred at Government Vellore Medical College and Hospital, a tertiary care hospital in Tamil Nadu. Data collected from case records and death reviews.Results: There was total of 71 deaths at the tertiary care hospital during the period January 2018 to December 2020 out of 31407 live births giving Maternal mortality rate of 226/1,00,000 live births. The MMR is high as it is a tertiary hospital catering referral from six districts. Most of the cases were due to late referrals. The majority of the deaths occurred in primigravida (50.7%), in the age group of 21 to 25 years (35.2%) and around term gestational age (49.3%). The most common cause of death in our study was hypertensive disorders of pregnancy (29.5%) followed by PPH (14.08%).Conclusions: From our study we concluded that the most common causes of maternal death were due to direct obstetric causes like severe pre-eclampsia, eclampsia and post-partum haemorrhage. Early identification of high-risk cases, early identification of GHT, anaemia and its correction, early referral of high-risk cases to tertiary centre can prevent most of the deaths. 


2020 ◽  
pp. 85-86
Author(s):  
Ekta Jauhari ◽  
Deepa Masand

Maternal mortality in India is a matter of concern. Heart disease complicates around 1-3% of all pregnancy and accounts for 10-15 % of maternal death1-3. It is a high risk condition. Its management is combined effort and vigilant monitoring of cardiologists and obstetricians.


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