scholarly journals Two year review of maternal mortality at a tertiary care hospital of GMERS, Valsad, Gujarat, India

2018 ◽  
Vol 7 (6) ◽  
pp. 2283
Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Mortality Ratio

Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.

scholarly journals Maternal mortality in tertiary care hospital: a 2-year review

2018 ◽  
Vol 8 (1) ◽  
pp. 184
Author(s):  
Juhi Ankit Patel ◽  
Kanaklata D. Nakum ◽  
Aditi Vithal ◽  
Mayank R. Lunagariya
Keyword(s):  
Maternal Mortality ◽  
Low Socioeconomic Status ◽  
Rural Areas ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Epidemiological Data ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Mortality Ratio ◽  
Set Up

Background: Epidemiological data pertaining to maternal mortality is valuable in each set up to design interventional programs to favourably reduce the ratio. This study was done to evaluate the maternal mortality rate in our hospital, to assess the epidemiological aspects and causes of maternal mortality, and to suggest recommendations for improvement.Methods: This was a 2-year retrospective study. Epidemiological data was collected from the Last 2 years of Facility Based Maternal Death Review Form. Maternal mortality ratio, epidemiological factors and causes affecting maternal mortality were assessed.Results: A total of 72 maternal deaths occurred. Most maternal deaths occurred in the age group of 20–24 years (40.27%), multiparous women (70.83%), women from rural areas (65.27%), illiterate women, unbooked patients (83.33%), and patients of low socioeconomic status. Direct causes accounted for 62.4% of maternal deaths where as 37.4% of maternal deaths were due to indirect causes.Conclusions: There is a wide scope for improvement as a large proportion of the observed deaths could be preventable.

scholarly journals An Audit of Maternal Mortality at a Tertiary Care Hospital

2021 ◽  
Vol 11 (4) ◽  
pp. 153-157
Author(s):  
Shazia Naseeb ◽  
Piranka Kumari ◽  
Iqra Jam ◽  
Haleema Yasmin
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Demographic Feature ◽  
Maternal Deaths ◽  
Live Births ◽  
Medical Disorders ◽  
Mortality Ratio

Objective:To find causes of maternal deaths and to calculate maternal mortality ratio at tertiary care hospital Karachi. Study Design and setting:An observational study was conducted from1st January 2019 to 31stDecember 2020 at theDepartment of Obstetrics & Gynecology Unit 1, JPMC Karachi. Methodology:Patients were selected according to inclusion criteria after ethical approval through non probability consecutivesampling technique. Details of patients were obtained from filesand record registers. Their demographic feature like age,parity, gestational age, booking status and presence or absence of medical disorders, their status of delivery and direct andindirect reasons of maternal deaths were noted and their frequency and percentages were calculated. Brought dead patientsand those who died accidently were excluded from the study. Results:During the period of two years the total numbers of deaths certified in the department were 90. Total number ofchild birth and live births were 19084 and 17892 respectively. The maternal mortality ratio was estimated as 503.01 per100,000 live births. Most of the patients 74(82.3%) were un booked. Direct Causes were about 67(74.5%). Haemorrhagewas found to be most common reason of maternal deaths in about21(23.3%). Eclampsia among18(20%) deaths. Anemia, cardiac disease, hepatic failure were the indirect causes of maternal deaths responsible for 23 (25.5%) of maternal deaths. Conclusion:Maternal Death rate is persistently elevated in JPMC, being tertiary care hospital mostly due to serious and referred complicated cases. Haemorrhage and eclampsia are still major killers of mothers as before.

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

2015 ◽  
Vol 8 (2) ◽  
pp. 86-91 ◽  
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.

scholarly journals A retrospective analysis of maternal mortality in an urban tertiary care hospital

2021 ◽  
Vol 11 (1) ◽  
pp. 197
Author(s):  
Nishu Bhushan ◽  
Aakriti Manhas ◽  
Anju Dogra
Keyword(s):  
Maternal Mortality ◽  
Medical Records ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Maternal Deaths ◽  
Mortality Ratio ◽  
Causes Of Deaths

Background: The aims of the study were to generate information regarding causes and complications leading to maternal deaths in an urban tertiary care centre and to find if any of the causes are preventable.Methods: The medical records of all maternal deaths occurring over a period of 4 years between January 2015 and December 2018 were reviewed.Results: Maternal mortality ratio ranged between 127 and 48 per 1, 00,000 births in the study. The causes of deaths were haemorrhage (29.47%), pregnancy-induced hypertension (PIH) (28.42%), anaemia (12.63%), sepsis (9.47%), thromboembolism (6.31%), hepatic causes (5.26%), blood reactions (3.15%), heart diseases (2.10%), central nervous system (CNS) related (1.05%) and others (2.10%). Maximum deaths occurred in women between 21-30 years of age. Mortality was highest in post-natal mothers (70.52%).Conclusions: Overall maternal mortality due to direct obstetric causes was (73.68%), indirect obstetric causes (22.10%) and unrelated causes (4.2%). 

scholarly journals A study to assess proportion of the maternal near miss to maternal death in a tertiary care teaching hospital of North East India

2020 ◽  
Vol 9 (6) ◽  
pp. 2486
Author(s):  
Pradip Sarkar ◽  
Jahar Lal Baidya ◽  
Ashis Kumar Rakshit
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Deaths ◽  
Live Births ◽  
Medical Disorders ◽  
Mortality Ratio

Background: The objective of present study was to assess the proportion of maternal near miss and maternal death and the causes involved among patients attending obstetrics and gynaecology department of Agartala Govt. Medical College of North Eastern India.Methods: Potentially life-threatening conditions were diagnosed, and those cases which met WHO 2009 criteria for near miss were selected. Maternal mortality during the same period was also analyzed. Patient characteristics including age, parity, gestational age at admission, booked, mode of delivery, ICU admission, duration of ICU stay, total hospital stay and surgical intervention to save the life of mother were considered. Patients were categorized by final diagnosis with respect to hemorrhage, hypertension, sepsis, dystocia (direct causes) anemia, thrombocytopenia, and other medical disorders were considered as indirect causes contributing to maternal near miss and deaths.Results: The total number of live births during the study period (January 2017 to June, 2018) was 9378 and total maternal deaths were 37 with a maternal mortality ratio of 394.5/1 lakh live births. Total near miss cases were 96 with a maternal near miss ratio of 10.24/1000 live births. Maternal near miss to mortality ratio was 2.6. Of the 96 maternal near miss cases - importantly 20.8% were due to haemorrhage, 19.8% were due to hypertension, 13.5% were due to sepsis, and 11.5% were due to ruptured uterus. In maternal death group (n-37), most important causes were hypertensive (40.5%) followed by septicemia (21.6%), haemorrhage (10.8).Conclusions: Haemorrhage, hypertensive disorders and sepsis were the leading causes of near miss events as well as maternal deaths.

scholarly journals Maternal mortality and its causes in a tertiary care hospital

2019 ◽  
Vol 8 (9) ◽  
pp. 3471
Author(s):  
Goter Doke ◽  
Jyoti Kamda
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Medical Science ◽  
Age Groups ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Maternal Deaths ◽  
Live Births ◽  
Induced Hypertension

Background: Maternal mortality is defined as the death of a woman while being pregnant or within 42 completed days of termination of pregnancy. The aim of this study was to study the maternal mortality and analyze the complications leading to maternal deaths.Methods: A retrospective study of hospital records and death summaries of all maternal deaths over the period of two year from April 2017 to March 2019 was conducted in the Department of Obstetrics and Gynecology, Tomo Riba Institute of Health and Medical Science, a tertiary level healthcare referral center in  Naharlagun, Arunachal Pradesh, India.Results: There was a total of 6 maternal deaths out of 6311 live births giving maternal mortality ratio (MMR) of 95.07 per 1,00,000 live births. The majority of deaths were reported in the age groups 30-40 years (66.66%). More deaths were reported in multiparous women (83.33%) as compared to primiparous women (16.66%). Most of them were unbooked cases (66.66%). Haemorrhage (33.33) and pregnancy induced hypertension (33.33%) were the major direct cause of maternal deaths.Conclusions: Haemorrhage and pregnancy induced hypertension were found to be major cause of maternal deaths. In our study, there was no maternal death from anemia and other medical disorder.

scholarly journals Maternal mortality assessment in a tertiary care hospital in Uttar Pradesh, India

2020 ◽  
Vol 9 (9) ◽  
pp. 3814
Author(s):  
Urvashi Barman Singh ◽  
Shakti Jain ◽  
Yashi Srivastava ◽  
Manisha Gupta ◽  
Meena Dayal
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Post Partum ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Medical College ◽  
Time Period

Background: Objective of this study was to calculate the maternal mortality rate in our hospital and to assess the epidemiological aspects and causes of maternal mortality to further analyse ways to reduce the maternal mortality rate (MMR).Methods: This was a retrospective analytical study done in the department of obstetrics and gynecology, MLN Medical College and District Women Hospital, Prayagraj over a time period of 10 years i.e., October 2009 to October 2019. Retrospective analysis and evaluation of the medical records and statistics was done to find out and collect specific causes of maternal deaths in the give time period.Results: There were 357 maternal deaths from October 2009 to October 2019. Maternal mortality rate in the study was calculated to be 498.42 per 1 lakh live births. Maximum deaths were in 21-30 years age group with multipara, unbooked and illiterate cases. Majority of the deaths reported were from direct causes of maternal mortality i.e., hemorrhage, hypertensive disorders and sepsis.Conclusions: In the selected hospitals, the mean maternal mortality rate in the study period was 498.42/100000 births. 71.4% had direct cause and 21.56% had indirect cause of maternal mortality several factors like regular antenatal visits, early identification of high-risk cases, timely referral, institutional deliveries, adequate post-partum care and follow-up can contribute to decrease the maternal mortality rate effectively.

scholarly journals Maternal mortality in a tertiary care hospital: a five-year review

2017 ◽  
Vol 6 (11) ◽  
pp. 4953
Author(s):  
Manjeet Kaur ◽  
Manjit K. Mohi ◽  
Sangeeta Aggarwal ◽  
Balwinder Kaur
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care Hospital ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Mortality Ratio ◽  
Causes Of Deaths

Background: This study was aimed at analyzing the maternal mortality ratio over five years, the causes leading to maternal deaths in a tertiary care hospital and factors which are preventable.Methods: The records of maternal death from August 2010 to July 2015 (5 years) were collected and analyzed. Various factors like maternal age, parity, literacy, place of residence, antenatal registration, admission-death interval, mode of delivery and causes of deaths were reviewed.Results: The mean maternal mortality ratio (MMR) was 1039. The direct causes of maternal mortality were hemorrhage (22.4%), eclampsia (21.2%), sepsis (18.78%) and amniotic fluid embolism (8.48%). Indirect obstetric deaths were due to hepatitis (10.9%), anemia (3.6%), respiratory diseases (6.06%), heart diseases (3.03%), CNS disease (5.45%).  Most of the deaths (69.7%) occurred in age group 20 and30 years. 63.6% were multigravida and 85.4% were unbooked cases.Conclusions: Antenatal care, screening and management of high risk pregnancies are most important to prevent complications and maternal deaths by timely detection and intervention.

Prevalence and Risk Factors for Maternal Mortality at a Tertiary Care Centre in Eastern Nepal- Retrospective Cross Sectional Study

2021 ◽  
Author(s):  
Sarita Sitaula ◽  
Tulasa Basnet ◽  
Ajay Agrawal ◽  
Tara Manandhar ◽  
Dipti Das ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Maternal Mortality ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Type I ◽  
Maternal Deaths ◽  
Live Births ◽  
Contributory Factors ◽  
Mortality Ratio

Abstract Background:Maternal mortality ratio is an important public health indicator that reflects the quality of health care services. The prevalence is still high in developing countries than in the developed countries. This study aimed to determine the MMR and to identify the various risk factors and causes of maternal mortality.Methods: This is a retrospective study conducted in a tertiary care center of Eastern Nepal from 16th July,2015 to 15th July 2020. Maternal mortality ratio per 100,000 live-births over 5 years of study period was calculated. The causes of death, delays of maternal mortality and different sociodemographic profiles were analyzed by descriptive statistics.Results:There were total of 55,667 deliveries conducted during the study period. The calculated maternal mortality ratio is 129.34 per 100,000 live-births in year 2015 to 2020. The mean age and gestational age of women having maternal deaths were 24.69 ±5.99 years and 36.15± 4.38 weeks of gestation respectively. The common causes of maternal deaths were obstetric hemorrhage, hypertensive disorder of pregnancy and sepsis. The leading contributory factors to the death were delay in seeking health care and delay in reaching health care facility (type I delay:40.84%).Conclusions:Despite the availability of comprehensive emergency obstetric care at our center, maternal mortality is still high and almost 75% of deaths were avoidable. The leading contributory factors were due to delay in seeking care and delayed referral from other health facilities. Contributory factors related to maternal mortality are preventable through combined safe motherhood strategies, prompt referral, active management of labor and puerperium.

scholarly journals Fifteen Uninterrupted Years of Maternal Mortality Findings from a Tertiary Care Centre

2021 ◽  
Vol 17 (3) ◽  
pp. 241-251
Author(s):  
Ashma Rana ◽  
Junu Shrestha ◽  
Suvana Maskey ◽  
Sudeep Kaudel ◽  
Prashant Shrestha ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Health Care Facilities ◽  
Maternal Deaths ◽  
Live Births ◽  
Infective Hepatitis ◽  
Mortality Ratio ◽  
The Impact

Introduction Maternal mortality reflects reproductive health status and availability of good health care facilities at different levels of the healthcare system at a given period, influenced by globally adopted safe motherhood policies. The leading causes of maternal death in Nepal mainly comprise of hemorrhage, eclampsia, abortion-related complications, gastroenteritis and anemia. Although a declining trend has been noted in Nepal it has yet to meet the target set by the Sustainable Development Goal (SDG) 3.1 of reducing the global MMR to less than 70 maternal deaths per 100,000 live births by 2030.  MethodsA cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Tribhuvan University Teaching Hospital (TUTH) from 1st Baisakh 2055- 30th Chaitra 2069 (15th April 1998- 14th April 2013). The study period of 15 years was divided into three parts, five years each: 2055-59 (14th April 1998-April 13th 2003) ; 2060-64 (14th April 2003- April 12th 2008) and 2065-69 (April 13th 2008 –April 12th 2013). MM was filled in Performa, discussed in morning conference and MM audit, computerized, analyzed, presented quarterly and yearly. Annual Maternal Mortality Ratio (MMR) expressed as MMR per 100,000 live births is calculated by dividing recorded (or estimated) maternal deaths by total recorded (or estimated) live births in the same period and multiplying by 100,000.  ResultsTotal MM/maternal mortality ratio (MMR) in the first, mid and last five years were 39 (270 %); 37 (212% ) and 37 (188%) respectively giving overall total MM/MMR 113 (223.5%) attributing to Direct: 55 ( 48.6%), Indirect: 44 (38.9%) and Non maternal deaths: 14 (12.3%). Predominating cause of MM in the first/mid/last five years were sepsis and infective hepatitis each (17.6%) and PPH (18.5 %). While SP/E were almost same over the years, in decreasing trend were hepatitis and puerperal sepsis but in rising trend was PPH and criminally induced abortion (10.6%). Thenumber of maternal death has not changed much, the median age in each five years is surprisingly similar, set at 25 years and the adolescents who died were not very different in every five years. It’s unfortunate that many primigravida died during this period which is a matter of concern.  ConclusionsMaternal mortality stresses the impact of timely health seeking behaviour and health providers making provision of prompt adequate services and referral to help so that all Nepalese mothers, especially the young and first-time pregnant thrive. Keywords: infective hepatitis, maternal mortality, maternal mortality ratio, PPH, sepsis.

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