scholarly journals Trends in causes of maternal mortality in a tertiary care centre in Kerala, India

2018 ◽  
Vol 7 (11) ◽  
pp. 4370
Author(s):  
Sreekumari U. ◽  
Shilpa Nair
Keyword(s):  
Maternal Mortality ◽  
Cause Of Death ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Maternal Mortality Ratio ◽  
Blood Component ◽  
Indian States ◽  
Maternal Deaths ◽  
Mortality Ratio ◽  
Study Setting

Background: Kerala has the lowest maternal mortality ratio compared to other Indian states. But when compared to developed countries Kerala has still a long way to go. The present study aimed to analyse the causes of maternal deaths that occurred in the study setting for a period of seven years (2011-2017).Methods: Retrospective study which was conducted at SAT hospital, Govt. Medical College, Thiruvananthapuram. All maternal deaths that occurred in the study setting from January 2011 to December 2017 were found out from registers. The baseline socio demographic characteristics, gravidity, parity, cause of death were recorded using structured proforma and analyzed using SPSS software.Results: Total maternal deaths during the time period was 101. There were 66441 live births. Maternal mortality ratio for the seven-year period was 152. Majority were primigravidae (50.49%), of low socio-economic status (79.2%), rural population (81.1%) and referred from periphery after identifying complication (85.1%). Caessarean section was the commonest mode of delivery among them (43.56%). Regarding cause of death, indirect maternal deaths were more than direct deaths (50.49% versus 42.57%). Cardiac disorder was the leading indirect cause (12.87%), Post-partum hemorrhage (13.86%), Hypertensive disorders (8.91%) and Sepsis (7.9%) were the leading direct causes.Conclusions: Early referral protocols, increasing blood and blood component availability in the periphery should be reinforced. Regarding indirect causes medical boards should be constituted in tertiary care centres for prompt and efficient multidisciplinary care.

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 The changing trends and tendencies in maternal mortality: a compare and contrast spanning two decades

2021 ◽  
Vol 10 (7) ◽  
pp. 2704
Author(s):  
Arunadevi G. ◽  
Vijayalakshmi N. ◽  
Sangeetha R.
Keyword(s):  
Maternal Mortality ◽  
Cause Of Death ◽  
Mode Of Delivery ◽  
Maternal Mortality Ratio ◽  
Maternal Deaths ◽  
Significant Difference ◽  
Centre Of Excellence ◽  
Mortality Ratio ◽  
Hypertensive Diseases ◽  
Compare And Contrast

Background: Though the maternal mortality ratio has been on the constant decline over two decades we shall strive forward to prevent all preventable maternal deaths and we have a long way to reach the SDG 3.1 goal. So, it becomes imperative to further reduce the mortality rates by continuously reviewing and upgrading our health policies. The aim of the study was to compare the trends in maternal mortality in 2002-2011 to the current predicament in 2017- 2019 in our hospital.Methods: Data was collected for all maternal deaths in the Institute of obstetrics and gynaecology, Egmore, Chennai- a centre of excellence for maternal care in South India, in terms of age at time of death, parity, period of death, mode of delivery, the cause of death and the admission to delivery interval and compared between the time periods of 2002-2011 and 2017-2019 to identify the changing patterns.Results: The maternal mortality ratio has consistently declined over the years from 220 in 2002 to 110 in 2019. The age group of 20-29 years and primigravidae continue to amount for most mortality. The postpartum period remains the most susceptible period. There is a significant increase in the number of caesarean deaths (64% from 46%). Significant transition in the cause of death from haemorrhage (20% to 7%) to hypertensive disease of pregnancy (23% to 35%) as leading cause of maternal mortality has been witnessed.Conclusions: Significant difference in the trends over two decades in maternal mortality lies in the fact that the leading cause of maternal mortality has changed from haemorrhage to hypertensive diseases and sepsis and they have continued to occupy the top spots for the past decade. Preventive measures are the solution to reduce maternal mortality due to either of the causes.

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.

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-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 MATERNAL MORTALITY

2009 ◽  
Vol 16 (01) ◽  
pp. 135-138
Author(s):  
TASNIM TAHIRA REHMAN ◽  
MAHNAZ ROOHI
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Level ◽  
Maternal Deaths ◽  
Mortality Ratio ◽  
Study Setting ◽  
Very High

Objective: To find out maternal mortality ratio (MMR) and to determine major causes of maternal death. S t u d y d e s i g n:A descriptive study. Setting: Department of Obstetric and Gynaecology, Allied Hospital, Faisalabad. S t u d y period: From 01.01.2008 to31.12.2008. Materials a n d m e t h o d s : All cases of maternal death during this study periods were included except accidental deaths. Results:There were 58 maternal deaths during this period. Total No. of live births were 5975. MMR was 58/5975 x 100,000 = 970/100,000 live births.The most common cause of maternal death was hemorrhage (34.5%) followed by hypertensive disorders/eclampsia (31%). Most of thepatients (75.86%) were referred from primary & secondary care level. C o n c l u s i o n : Maternal mortality is still very high in underdevelopedcountries including Pakistan. We must enhance emergency obstetric care (EOC) to achieve the goal of reduction in MMR.

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 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 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.

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.

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