scholarly journals Maternal mortality by direct obstetric causes in an urban referral hospital: case of Boulmiougou District Hospital in Ouagadougou, Burkina Faso

2019 ◽  
Vol 8 (8) ◽  
pp. 3009
Author(s):  
Yobi Alexis Sawadogo ◽  
Hyacinthe Zamané ◽  
Sibraogo Kiemtoré ◽  
Sansan Rodrigue Sib ◽  
Dantola Paul Kain ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Analytical Study ◽  
District Hospital ◽  
Contributing Factors ◽  
Childbearing Age ◽  
Continuous Training ◽  
Cross Sectional ◽  
Maternal Deaths ◽  
Pregnancy And Childbirth ◽  
Technical Platform

Background: Complications during pregnancy and childbirth are the leading causes of death and disability for women of childbearing age. Objective of this study was to study maternal mortality of direct obstetric origin at the Boulmiougou district hospital from 2010 to 2014.Methods: This was a retrospective cross-sectional descriptive and analytical study of maternal deaths by direct obstetric cause at the maternity ward of Boulmiougou District Hospital during the period from January 1st 2010 to December 31st, 2014, i.e. 5 years.Results: The maternal mortality rate by direct obstetric cause of 147.68 maternal deaths per 100,000 live births. The average age of the patients was 27.09 years old. The direct causes of maternal death were hemorrhage (47.06%), hypertensive disorders (20.59%), infections (14.71%) and unsafe abortion (11.76%). Contributing factors to maternal deaths were delay in evacuation (47.06%) and delay in care (38.23%).Conclusions: Maternal mortality remains high in the Boulmiougou District Hospital. To effectively combat maternal mortality, it is important to focus on the continuous training of staff and the strengthening of the technical platform.

DEMOGRAPHIC AND HEALTH STATUS RISK FACTORS IN CHILDBEARING AMONG INDIAN WOMEN. EVIDENCE FROM HOSPITAL DATA FOR THE LATER STAGES OF FERTILITY DECLINE

2000 ◽  
Vol 32 (2) ◽  
pp. 191-206 ◽  
Author(s):  
KIRSTY MCNAY
Keyword(s):  
Health Status ◽  
Maternal Mortality ◽  
Fertility Decline ◽  
Poor Health ◽  
Low Fertility ◽  
Hospital Data ◽  
Poor Health Status ◽  
Maternal Deaths ◽  
Pregnancy And Childbirth ◽  
Increase In Risk

Indirect estimates of maternal mortality in India indicate that fertility decline has reduced maternal deaths by reducing the frequency of pregnancy and childbirth. The earlier stages of fertility decline are also likely to have lowered maternal mortality by reducing the risk of pregnancy and childbirth as the proportion of births among risky multiparous, older women declines. However, further fertility decline may well be associated with some increase in risk. Risk will also remain high if the health status of Indian girls and women remains poor. This study uses a sample of maternal deaths and deliveries among patients who survived which occurred in Civil Hospital, Ahmedabad, Gujarat during 1982–1993 to investigate these issues further. The women in the sample have relatively low fertility and represent a fairly late stage of fertility decline. They also have persistently poor health status. Logit regression analysis reveals that although fertility decline is associated with some increase in risk, poor health status is the more important maternal mortality risk factor. Without attention to female health, even childbearing among expectant mothers with low fertility continues to be hazardous.

scholarly journals Factors Affecting Home Delivery among Women Living in Remote Areas of Rural Zambia: A Cross-Sectional, Mixed-Methods Analysis

2021 ◽  
pp. 1-13
Author(s):  
Ireen Chola Mwape Musonda
Keyword(s):  
Maternal Mortality ◽  
Health Facility ◽  
Low Income ◽  
Rural Areas ◽  
Home Delivery ◽  
Childbearing Age ◽  
Long Distance ◽  
Cross Sectional ◽  
Home Deliveries ◽  
At Home

Luapula Province has the highest maternal mortality and one of the lowest facility-based births in Zambia. The distance to facilities limits facility-based births for women in rural areas. In 2013, the government incorporated maternity homes into the health system at the community level to increase facility-based births and reduce maternal mortality. Despite the policy to stopping traditional birth attendants from conducting deliveries at home and encouraging all women to give birth at the health facility under skilled care, many women still give birth at home. An exploratory cross section survey was used to gather data by conducting structured interviews with 50 women of childbearing age who had a recent or previous home delivery. The following factors were found to be associated with home deliveries in surrounding villages in kashikishi; abrupt onset/precipitate labor, long distance/transport difficulties to reach the nearest health facility, having had successful HD, poverty/low income and gender though having a small percentage. Parity in which the majority were multiparas’ women, attitude was also associated with home deliveries and other unforeseen circumstances such as a funeral and being alone at home at the onset of labour.

scholarly journals Harmful cultural practices during perinatal period and associated factors among women of childbearing age in Southern Ethiopia: Community based cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254095
Author(s):  
Haimanot Abebe ◽  
Girma Alemayehu Beyene ◽  
Berhanu Semra Mulat
Keyword(s):  
Cultural Practices ◽  
Perinatal Period ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Community Based ◽  
Cross Sectional ◽  
Pregnancy And Childbirth ◽  
Harmful Cultural Practices

Introduction Although the maternal mortality ratio has decreased by 38% in the last decade, 810 women die from preventable causes related to pregnancy and childbirth every day, and two-thirds of maternal deaths occur in Sub-Saharan Africa alone. The lives of women and newborns before, during, and after childbirth can be saved by skilled care. The main factors that prevent women from receiving care during pregnancy and childbirth are harmful cultural practices. The aim of this study was to assess the level of harmful cultural practices during pregnancy, childbirth, and postnatal period, and associated factors among women of childbearing age in Southern Ethiopia. Methods A community-based cross-sectional study design was conducted in the Gurage zone, among representative sample of 422 women of reproductive age who had at least one history of childbirth. A simple random sampling technique was used to recruit participants. Data were collected by six experienced and trained data collectors using a pretested structured questionnaire with face to face interviews. Harmful cultural practices are assessed using 11 questions and those who participate in any one of them are considered as harmful cultural practices. Descriptive statistics were performed and the findings were presented in text and tables. Binary logistic regression was used to assess the association between each independent variable and outcome variable. Results Harmful cultural practices were found to be 71.4% [95%CI, 66.6–76.0]. The mean age of study participants was 27.6 (SD ± 5.4 years). Women with no formal education [AOR 3.79; 95%CI, 1.97–7.28], being a rural resident [AOR 4.41, 95%CI, 2.63–7.39], having had no antenatal care in the last pregnancy [AOR 2.62, 95%CI, 1.54–4.48], and pregnancy being attended by untrained attendants [AOR 2.67, 95%CI, 1.58–4.51] were significantly associated with harmful cultural practice during the perinatal period. Conclusion In this study we found that low maternal education, rural residence, lack of antenatal care and lack of trained birth attendant were independent risk factors associated with women employing harmful cultural practices during the perinatal period. Thus, strong multi-sectoral collaboration targeted at improving women’s educational status and primary health care workers should take up the active role of women’s health education on the importance of ANC visits to tackle harmful cultural practices.

scholarly journals Maternal Mortality in Paraguay tendencies and risk factors: 2004-2015

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Villalba ◽  
M Sánchez
Keyword(s):  
Maternal Mortality ◽  
Health Care Access ◽  
Cross Sectional Study ◽  
Vital Statistics ◽  
Cross Sectional ◽  
Maternal Deaths ◽  
Significance Level ◽  
The Sustainable Development ◽  
The Difference

Abstract Background Maternal mortality remains a serious challenge worldwide, it being part of the Sustainable Development Goals. Progress is tracked through maternal mortality ratios (MMR), which demonstrate the current development of a health system. Our study describes tendencies and factors involved in the MMR in Paraguay, South America. Methods A retrospective cross-sectional study was undertaken. Data were extracted from the national system of vital statistics published by the Ministry of Public Health and Social Welfare. MMR was expressed as the number of maternal deaths per 100,000 live births. The causes of maternal deaths were classified according to the CIE-10. The tendency and fluctuations of the variables were analyzed through Pearson and Spearman correlations. A significance level of 5% was established. Results During the period of 2004-2015 in Paraguay there was a significant reduction in the tendency of the number of maternal deaths (r= -0.895; p < 0.001) with a decrease of 37.1%; Accordingly, there is a decreased tendency of the MMR (r= -0.929; p < 0.001) with a reduction of 45.4% and an annual mean decrease of 3.95%. It was observed that women aged 40 years and older and women characterized as single possessed a higher MMR, with each group showing 317.7/100 000 and 377.5/100 000, respectively. The 75% of death causes were Postpartum Hemorrhage, Eclampsia, Concurrent maternal deaths, Abortion and Puerperal Sepsis. Conclusions Our study showed significant decreased tendency of MMR, although remaining high compared to high income countries. More studies to support this result are recommended due to the difference with international estimates. The main causes of death showed the need to strengthen prenatal follow-up in primary care far from high-complexity hospitals. Key messages Our study describes the situation on Maternal Mortality in a developing country, showing the importance of health care access and prenatal follow up for preventable complications. Our work showed the urgent need for more studies about abortion prevalence and also to determine the cause of higher MMR on single women in our country.

scholarly journals The Association between Maternal Mortality and Non-Medical factors in African Countries

2014 ◽  
Vol 6 (5) ◽  
pp. 351-362
Author(s):  
P. Lalthapersad-Pillay
Keyword(s):  
Developing Countries ◽  
Logistic Regression ◽  
Maternal Mortality ◽  
National Income ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Maternal Deaths ◽  
Medical Factors ◽  
Pregnancy And Childbirth ◽  
Sub Saharan

The medical expertise to treat to complications arising from pregnancy and childbirth has not spared girls and women in developing countries from dying of such conditions. Developing countries account for the bulk of the global share of maternal deaths with complications of pregnancy and childbirth being the leading cause of death in young women aged between 15 and 49. Sub-Saharan Africa is responsible for nearly three-fifths of all global maternal deaths which have saddled it with notoriously high levels of maternal mortality ratios, a concern that has been red-flagged internationally and regionally. Most studies on maternal mortality in Africa have been confined to an examination of factors impinging on maternal mortality from both medical and socioeconomic standpoints for individual country’s based on survey data. Our study differs from others as it employs logistic regression to look at the association between non-medical factors and maternal mortality nationally for all African countries. Whilst the results from the logistic regression suggests that there is no statistically significant relationship between any of the variables and maternal mortality, the odds ratio for Human Development Index (HDI) and Gross National Income per capita (GNI) imply that African countries with low HDI are about three time more likely to have high maternal mortality compared to high HDI countries. Similarly, African countries with low GNI are about five times more likely to have high maternal mortality compared to high GNI countries.

scholarly journals Maternal Mortality and Associated Factors in a Tertiary Care Center of Western Nepal

2017 ◽  
Vol 5 (2) ◽  
pp. 58-63
Author(s):  
Junu Shrestha ◽  
Sangeeta Gurung ◽  
Ashika Shrestha ◽  
Anjali Subedi
Keyword(s):  
Health Care ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Care Center ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Medical Personnel ◽  
Educational Status ◽  
Cross Sectional ◽  
Maternal Deaths

Introduction: Identifying the cause of maternal death is important. The aim of this study was to determine the causes of maternal deaths and the factors associated with it. Methods: This was an observational, cross-sectional, analytical study conducted at Department of Obstetrics and Gynecology, Manipal Teaching Hospital from July 2013 to June 2017. Women who died during pregnancy, delivery, or puerperium were included in the study. Demographic factors, clinical profile, cause and type of maternal deaths were noted by taking history and by inquiring with the medical personnel involved in managing patients.  Data analysis was done using SPSS version 16. Results: There were 15 maternal deaths and 9923 livebirths. The maternal mortality ratio was 151 per 100,000 live births. Mean age of mothers was 28 years (SD = 7.5). Most of them were from rural areas, had low educational status. The mean gestational age at time of death was 33 weeks (SD = 7.5). Most of deaths (73%, n = 11) occurred in the postnatal period and 60% (n = 9) were critical at presentation. Direct obstetric causes like eclampsia was the most common (26.7%, n = 4) direct obstetric cause and cardiac disease was one of the important indirect cause (13.3%, n = 2). Delay in seeking health care and delay in reaching health center was the major reason for maternal deaths. Conclusion: Maternal mortality were mostly associated with direct obstetric causes, eclampsia being the most common. Most of the deaths were associated with delay in seeking health care and reaching health care centers.

scholarly journals Maternal Mortality Rate at East Ogan Komering Ulu (East OKU) Regional Public Hospital Over a Four Year Period: Trends, Its Associated Factors and Neonatal Outcome

2019 ◽  
pp. 97-100
Author(s):  
Cindy Kesty ◽  
Hendra S Saputra
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Associated Factors ◽  
Public Hospital ◽  
Neonatal Outcome ◽  
Downward Trend ◽  
Hypertensive Disorder ◽  
Childbearing Age ◽  
Maternal Deaths ◽  
Maternal Mortality Rate

Objective: To determine the MMR trends, its associated factors, and neonatal outcome at East OKU Regional Public Hospital from 2013 until 2016. Methods: This descriptive study was performed from January 2013 until December 2016 in maternity ward and Intensive Care Unit (ICU) of East OKU Regional Public Hospital, South Sumatera. Data was collected from medical records. There were 17 maternal deaths, but 1 data was excluded due to lack of data. Results: We recorded 2,191 pregnancies and 17 maternal deaths. Over 4 years, the lowest MMR occurred in 2013 (229/100,000) and achieved its peak in 2014 (1,306/100,000). Then, MMR followed downward trend dropping from 1,087/100,000 in 2015 until 588/100,000 in 2016. Most of deceased were childbearing age women (50.0%), multigravida (62.5%), but nulliparous (50.0%), and aterm (87.5%). The major etiology of maternal deaths were hypertensive disorder (37.5%), followed by hypertensive disorder + hemorrhage and hypertensive disorder + infection in the same proportion. MMR were higher in inborn cases (87.5%), born via C-section (87.5%), and treated for less than 48 hours (93.75%). Alive neonatal were born in most cases (62.5%). Conclusion: MMR trends in our hospital were fluctuating with a downward trend, but still much higher than the MDGs target in 2015 (102/100,000). Hypertensive disorder plays significant role in maternal deaths. In addition, most of neonates were born alive. We hope that this study can be a feedback for hospital to do maternal and perinatal audit. Keywords: Factors, Maternal mortality rate, Neonatal outcome, Regional public hospital, Trends     Tujuan: Untuk menentukan pola, faktor yang berkaitan, dan luaran neonatus di RSUD OKU Timur dari 2013 hingga 2016. Metode: Studi deskriptif dilakukan dari Januari 2013 hingga Desember 2016 di bangsal kebidanan dan unit perawatan intensif RSUD OKU Timur, Sumatera Selatan. Data dikumpulkan dari rekam medik. Terdapat 17 kematian ibu, tetapi 1 data dieksklusi karena data yang kurang lengkap. Hasil: Terdapat 2.191 kehamilan, dan 17 kematian ibu. Selama 4 tahun, AKI terendah terjadi pada 2013 (229/100.000) dan mencapai puncaknya pada 2014 (1.306/100.000). Kemudian, AKI mengalami penurunan dari 1.087/100.000 pada 2015 hingga 588/100.000 pada 2016. Mayoritas sampel berusia reproduktif (50,0%), multigravida (62,5%) dan nulipara (50,0%), serta aterm (87,5%). Mayoritas kematian ibu disebabkan oleh hipertensi dalam kehamilan (HDK) (37,5%), diikuti oleh HDK + perdarahan dan HDK + infeksi dalam jumlah yang sama. AKI lebih tinggi pada ibu yang melahirkan di RS (87,5%), melahirkan melalui sectio caesaria (87,5%), dan dirawat selama kurang dari 48 jam (93,75%). Mayoritas neonatus dilahirkan hidup (62,5%). Kesimpulan: Pola AKI di RSUD berfluktuasi dengan pola menurun, tetapi masih jauh lebih tinggi dari target MDGs pada tahun 2015 (102/100,000). Hipertensi dalam kehamilan berperan signifikan terhadap kematian ibu. Mayoritas neonatus dilahirkan hidup. Studi ini diharapkan dapat menjadi masukan bagi rumah sakit untuk melakukan audit maternal dan perinatal. Kata kunci: Angka kematian ibu, Faktor, Luaran neonatus, Pola, Rumah sakit umum daerah

scholarly journals Levels and determinants of maternal mortality in northern and southern Nigeria

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Catherine Meh ◽  
Amardeep Thind ◽  
Bridget Ryan ◽  
Amanda Terry
Keyword(s):  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Demographic And Health Surveys ◽  
Women Of Childbearing Age ◽  
The South ◽  
Childbearing Age ◽  
Maternal Deaths ◽  
The North ◽  
Determinants Of Maternal Mortality ◽  
North And South

Abstract Background Maternal mortality is still a major risk for women of childbearing age in Nigeria. In 2008, Nigeria bore 14% of the global burden of maternal mortality. The national maternal mortality ratio has remained elevated despite efforts to reduce maternal deaths. Though health disparities exist between the North and South of Nigeria, there is a dearth of evidence on the estimates and determinants of maternal mortality for these regions. Methods This study aimed to assess differences in the levels and determinants of maternal mortality in women of childbearing age (15–49 years) in the North and South of Nigeria. The Nigeria Demographic and Health Surveys (2008 and 2013) were used. The association between maternal mortality (outcome) and relevant sociocultural, economic and health factors was tested using multivariable logistic regression in a sample of 51,492 living or deceased women who had given birth. Results There were variations in the levels of maternal mortality between the two regions. Maternal mortality was more pronounced in the North and increased in 2013 compared to 2008. For the South, the levels slightly decreased. Media exposure and education were associated with maternal mortality in the North while contraceptive method, residence type and wealth index were associated with maternal death in the South. In both regions, age and community wealth were significantly associated with maternal mortality. Conclusions Differences in the levels and determinants of maternal mortality between the North and South of Nigeria stress the need for efforts to cut maternal deaths through new strategies that are relevant for each region. These should improve education of girls in the North and access to health information and services in the South. Overall, new policies to improve women’s socioeconomic status should be adopted.

scholarly journals MATERNAL MORTALITY 2007-2008

2010 ◽  
Vol 17 (02) ◽  
pp. 291-294
Author(s):  
AISHA ABDULLAH SHAIKH ◽  
SADIA SABOOHI ◽  
RUBINA A D MEMON
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Case Series ◽  
Medical College Hospital ◽  
Contributing Factors ◽  
College Hospital ◽  
Maternal Deaths ◽  
Medical College ◽  
Case Series Study

Objectives: To analyse the maternal mortality with its causes and possible contributing risk factors at Ghulam Mohammad Mahar Medical College Hospital, Sukkur. Setting: This study was carried out at Gynae / Obs Unit-1 of Ghulam Mohammad Mahar Medical College Hospital, Sukkur from Jan-2007 to Dec-2008. Study Design: Descriptive case series study. Subjects and Methods: This study was conducted by analysing the death records of all maternal deaths who died over a period of two (02) years from Jan 2007 to Dec 2008. Thedemographic record included age, parity, booking status and education. The cause of death and possible contributing factors were evaluated. Results: 48 mothers died during this period making Maternal Mortality Ratio (MMR) of 1578/ 100,000 live births. Direct causes contributed to 79% (38) of maternal deaths while 21% (10) were due to indirect causes. The major causes of deaths were eclampsia 27% (13), haemorrhage33% (11), Sepsis 21% (10), Obstructed labour 8% (4). Among indirect causes, hepatic encethalopathy, anemia and renal failure were observed. Conclusions: Eclampsia, haemorrhage and Sepsis are still the major killers. Factors which need urgent improvement include education, antenatal booking, early diagnosis and referrals to tertiary care centers.

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