scholarly journals Analysis of maternal mortality at tertiary care centre

2021 ◽  
Vol 10 (12) ◽  
pp. 4454
Author(s):  
Hemalatha S. V. ◽  
Manickadevi M. S.
Keyword(s):  
High Risk ◽  
Maternal Mortality ◽  
Early Identification ◽  
Tamil Nadu ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Live Births

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. 

scholarly journals Study of maternal mortality in a tertiary care hospital in a tribal KBK area of Odisha, India

2020 ◽  
Vol 9 (4) ◽  
pp. 1528
Author(s):  
Sasmita Behuria ◽  
Jyoti Narayan Puhan ◽  
Subhra Ghosh ◽  
Bhabani Sankar Nayak
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care Hospital ◽  
Physiological State ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Safe Motherhood ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Live Births ◽  
Hypertensive Disorders In Pregnancy

Background: Pregnancy, although being considered a physiological state, carries risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labor, or thereafter. The major causes of maternal mortality are mostly preventable through regular antenatal check-up, proper diagnosis, and management of labor complications. Therefore, the factors at different levels affecting the use of these services need to be clearly understood. The aim is to study the incidence of MMR, assess the epidemiological aspects, causes of maternal mortality and avoidable factors that can prevent maternal deaths.Methods: A retrospective hospital-based study was conducted in obstetrics and gynecology department, SLN MCH, a tertiary care referral hospital in a tribal area of southern Odisha over a period of 2 years from April 2017 to March 2019.Results: A total of 108 deaths were analyzed over 2 years period and MMR was calculated to be 1124/1 lakh live births. Most of the maternal deaths occurred in the age group of 20-24 years (35.1%), majority of maternal deaths were observed in multipara (46.3%), 70.3% deaths occurred within 24 hours of admission. Hypertensive disorders in pregnancy (37%) were the leading direct cause followed by hemorrhage (14.8%) and sepsis (11.1%). Among the indirect causes jaundice (7.4%) and anaemia (3.7%) were the leading cause.Conclusions: MMR in our study was very high as compared to national average of 167/1,00,000 live births, being a tertiary care hospital as most of the patients were referred from peripheral centers. Most maternal deaths are preventable by intensive health education, basic obstetric care for all, strengthening referral and communication system and emphasizing on overall safe motherhood.

scholarly journals Cut Throat Injury: A Tertiary Care Centre Experience

2021 ◽  
Vol 29 (1) ◽  
pp. 60-65
Author(s):  
Devang Gupta ◽  
Chaitry Shah ◽  
Vaishali Jain ◽  
Nikita Ganvit
Keyword(s):  
Tertiary Care Hospital ◽  
Primary Repair ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Common Cause ◽  
Vessel Injury ◽  
Major Vessel ◽  
Zone Ii

Introduction Cut throat injuries are one of the challenging emergencies encountered in clinical practice. This study evaluates the causes and management of cut throat injuries.   Materials and Methods This was a retrospective study of total 100 cases of cut throat injury presented to the department of ENT in a tertiary care hospital in Ahmedabad between June 2017 and June 2019. Majority of patients were managed by suturing.   Results In our study 69% were males,31% were females. The peak age of incidence is 4th decade (55%). 70% of them have injury in Zone II. Seventy eight percent of the patients presented with active bleed without major vessel injury. The most common cause of cut throat injury had been found to be accidental (75%), 54% had injury up to muscular layer. Five patients were managed by laryngotracheal stent placement. Conclusion The middle aged males were mostly affected. The majority had zone 2 injury.  The most common cause was Accidental (seasonal manja/ kite thread cut). Primary repair is the best way to avoid complications.

scholarly journals Descriptive audit of maternal sepsis in a tertiary care centre of North India

2017 ◽  
Vol 7 (1) ◽  
pp. 124
Author(s):  
Archana Kumari ◽  
Jyotsna Suri ◽  
Pratima Mittal
Keyword(s):  
Critical Care ◽  
Maternal Mortality ◽  
Critical Care Unit ◽  
Tertiary Care ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Live Births ◽  
Source Of Infection ◽  
Maternal Sepsis

Background: Maternal sepsis is one of the leading causes of maternal mortality around the world. The aim of this study was to study the prevalence, clinical profile and fetomaternal outcome of maternal sepsis at a dedicated Obstetric critical care unit of a tertiary care centre of North India. It was retrospective study conducted in tertiary care centre in North IndiaMethods: Women diagnosed as sepsis or septic shock at any point in pregnancy and up to 6 weeks postpartum (irrespective of the source of infection) were included in the study. Demographic, clinical, microbiological and outcome data were recorded from the case sheets of all patients admitted in obstetrical critical care unit between January to December 2016. Outcome measures: Prevalence, bacterial organism, source of infection, mode of delivery, period of gestation, maternal and fetal outcome.Results: The prevalence of maternal sepsis was 16.5/10,000 live births. The number of maternal deaths attributable to sepsis were 35, making the maternal mortality ratio due to sepsis 128/100,000 live births. 87% of the cases were unbooked. 22% presented antenatally while 58% were postpartum and 20% were postabortal. Genital tract infection was most common source of infection. E. coli was the predominant organism in 28% followed by Methicillin resistant staphylococcus aureus in 12%. The mortality from sepsis was very high (78%). 54% of cases required mechanical ventilation and around 7% had to be shifted to intensive care unit for advanced life support and care. Sepsis was associated with preterm delivery and a high perinatal mortality rate.Conclusions: Early recognition of the severity of infection and prompt management by a multidisciplinary team of intensivists, anesthetists, neonatologists, obstetrician, midwives are the key to success. Vigilant infection control measures must be strictly practiced during all pregnancy events.

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

2017 ◽  
Vol 6 (4) ◽  
pp. 1610 ◽  
Author(s):  
Surekha N. Khandale ◽  
Kshama Kedar
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
Maternal Mortality ◽  
Maternal Death ◽  
District Hospital ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Maternal Deaths ◽  
Great Loss

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.

scholarly journals STUDY OF FETO-MATERNAL OUTCOME AMONG PREGNANT WOMEN WITH CARDIAC DISEASE AT TERTIARY CARE CENTRE

2020 ◽  
pp. 85-86
Author(s):  
Ekta Jauhari ◽  
Deepa Masand
Keyword(s):  
Heart Disease ◽  
High Risk ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Cardiac Disease ◽  
Tertiary Care ◽  
Maternal Outcome ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Risk Condition

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.

scholarly journals Prevalence of congenital anomalies in babies and associated maternal etiological factors at tertiary care hospital

2021 ◽  
Vol 10 (11) ◽  
pp. 4189
Author(s):  
Shahana I. Chandniwala
Keyword(s):  
Congenital Anomalies ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Centre ◽  
Maternal Risk Factors ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Maternal Risk ◽  
Factors Associated

Background: The objective of this study was to know the local prevalence of congenital anomaly and study the maternal risk factors associated with it.Methods: Cross sectional descriptive study was carved out. All live babies were examined for presence of congenital anomalies and mother were looked for presence of socio-demographic factor.Results: In this study of 1 year 5767 live birth took place at tertiary care centre out of which 63 babies had congenital anomalies. Therefore, prevalence of congenital anomalies at tertiary care centre was 1.08%.Conclusions: The incidence of malformations were significantly higher in babies born to mothers over the age of 35 years and with parity 4 and above. 

scholarly journals Incidence and determinant of eclampsia and its associated complication in tertiary care hospital of Gujarat

2019 ◽  
Vol 9 (1) ◽  
pp. 221
Author(s):  
Chirag Banker ◽  
Latika Mehta
Keyword(s):  
Sampling Method ◽  
Tertiary Care Hospital ◽  
Economic Status ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Obstetrics And Gynaecology ◽  
Antenatal Visits

Background: Eclampsia is one of common cause of maternal mortality in developing country like India. It can be detected and prevented if early ANC care is properly done. Mainstay of management in case of eclampsia is early delivery to improve the prognosis in terms of reducing maternal and perinatal morbidity and mortality.Methods: This prospective study was carried out in the department of obstetrics and gynaecology, at tertiary care centre in the state of Gujarat, for a period of two years from July 2012 to June 2014. With purposive sampling method all patients admitted with complain of eclampsia is included in study. Details are taken in predesigned, pre-validated and prescribed proforma.Results: Hospital based incidence of eclampsia in our study is 1.11%. Majority of the patient were unbooked. Eclampsia is a disease of young primigravida, specifically teenage primigravida. Seventy-five percentage of eclampsia cases occurred in the antenatal period, 14% in intranatal period and 11% in the postnatal period.Conclusions: In developing countries like India still eclampsia is major problem. Good antenatal care with increased antenatal visits may help in reducing the incidence. Increased incidence among young primigravida and low socio-economic status group provides the target group for medical measures.

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 Preoperative Fear, Operative Gear, and Postoperative Care, in Tracheostomy during Covid Times – Our Experience at a Tertiary Care Hospital

2021 ◽  
Vol 10 (31) ◽  
pp. 2378-2383
Author(s):  
Ginni Datta ◽  
Sumit Narang ◽  
Manish Gupta ◽  
Soniya Arora
Keyword(s):  
Team Member ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Upper Airway ◽  
Daily Basis ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Aerosol Exposure ◽  
Key Words Aerosol

BACKGROUND The SARS-CoV-2 is known to be highly contagious from respiratory tract droplets and aerosol exposure. ENT surgeons deal with the upper airway and are exposed to aerosol generating procedures on a daily basis. Aerosol generating procedure such as tracheostomy is necessary in patients with head and neck cancers having airway obstruction. METHODS We share our experience of 38 cases where we had to perform tracheostomy during these Covid times under various circumstances in a tertiary care centre with a dedicated Covid Isolation centre for 5 districts with 210 beds reserved for Covid patients. RESULTS All 38 tracheostomies were performed successfully following the guidelines formulated by our team, with proper precautions not a single team member got infected with Covid-19. No test is 100 % sensitive, so all precautions must be taken while dealing with every patient and PPEs should be used in all tracheostomies. CONCLUSIONS No test is 100 % sensitive, so all precautions must be taken while dealing with every patient and PPEs should be used in all tracheostomies. Our policy of anticipating tracheostomy in patients with impending stridor helped us reduce the risk of having to perform emergency tracheostomies with Covid status unknown. KEY WORDS Aerosol, COVID-19, PPE - Kit, SARS-CoV-2, Stridor, Tracheostomy

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