Comparison of Causes of Maternal Mortality in the Limpopo Province between 2011/13 and 2014/16: Findings from the National Committee of Confidential Enquiry into Maternal Deaths in South Africa

2019 ◽  
Author(s):  
Sam Ntuli ◽  
Maboya EM ◽  
FLM Hyera ◽  
S Naidoo
Keyword(s):  
South Africa ◽  
Pulmonary Embolism ◽  
Maternal Death ◽  
Statistical Significance ◽  
Limpopo Province ◽  
National Committee ◽  
Confidential Enquiry ◽  
Maternal Deaths ◽  
Hypertensive Disorders ◽  
Obstetric Haemorrhage

Abstract Objective To review and compare underlying causes of maternal deaths in Limpopo Province (LP) using data of the National Committee of Confidential Enquiry into Maternal Deaths in South Africa (NCCEMD). Method This is a review of the findings of the causes of maternal deaths from the two trienniums 2011-2013 and 2014-2016 of the NCCEMD. When pregnancy related deaths occur a maternal death notification form is completed and submitted to the provincial Maternal, Child and Women's Health (MCWH) units. The provincial assessors assess the death and forward the report to the NCCEMD, where the data are collated and analyzed to provide summary estimates for the extent of important public-health problems. Results In the triennial 2011/13, 750 women deaths were recorded in LP of which 728 (97.1%) were maternal deaths and 22(2.9%) were coincidental deaths. While in the triennial 2014/16, of the 623 women deaths, 607(97.4%) were maternal deaths and 16 (2.6%) were coincidental deaths. In both trienniums, non-pregnancy related infections, obstetric haemorrhage, pregnancy-induced hypertensive disorders and medical and surgical disorders were the leading cause of deaths and accounted for two-thirds of maternal deaths. The number of deaths due to non-pregnancy related infections significantly decreases from 228 to 135 (p<0.05), while deaths due to medical and surgical disorders slightly increased (from 66 to 69, p>0.05). There was a marked reduction in the number of obstetric haemorrhage, pregnancy-induced hypertensive disorders, pregnancy-related sepsis, anaesthetic complications, ruptured ectopic pregnancy and acute collapse-cause unknown but the result did not reach statistical significance (p>0.05), and deaths due to miscarriage increased (p>0.05). The number of deaths due to pulmonary embolism increased significantly (p<0.05). Conclusion Although there is a reduction in the number of maternal deaths in LP, non-pregnancy related infections, obstetric haemorrhage, pregnancy-induced hypertensive disorders and medical and surgical disorders remain the major causes of maternal death and pulmonary embolism is an emerging concern.

scholarly journals Obstetrical Haemorrhagic Mortality in a Tertiary Hospital of the Limpopo Province, South Africa

2017 ◽  
Vol 1 (1) ◽  
pp. 42
Author(s):  
Sam T Ntuli
Keyword(s):  
South Africa ◽  
Maternal Death ◽  
Post Partum ◽  
Tertiary Hospital ◽  
Limpopo Province ◽  
Hospital Death ◽  
Maternal Deaths ◽  
Obstetric Haemorrhage ◽  
District Hospitals ◽  
Post Partum Haemorrhage

<p><strong><em>Background</em></strong><em>:</em><em> </em><em>Obstetric haemorrhage is potentially fatal. Its frequency</em><em> </em><em>contributes to assessment of population health. So this study purpose was to</em><em> assess the maternal death</em><em>s</em><em>due to obstetric haemorrhage in a tertiary hospital of the Limpopo Province, South Africa. </em></p><p><strong><em>Methods</em></strong><em>:</em><em> </em><em>All</em><em>maternal deaths, which occurred at Pietersburg Hospital</em><em>from January 2011 to December 2015 were reviewed.</em><em> The hospital death register was used to collate the list of maternal deaths</em><em>.Maternal</em><em>age, parity, referring facility, date of admission and death, ward where death occurred, and causes of death</em><em>were collected from delivery registers and patient medical records.</em><em></em></p><p><strong><em>Results</em></strong><em>: There were 232 maternal deaths of which 48 (20.7%) were due to obstetrical haemorrhage.</em><em> </em><em>The mean age of the </em><em>48</em><em> </em><em>women</em><em> </em><em>was </em><em>31.7±6.7 year range 15-48 years</em><em>.</em><em> Thirty one of 48 haemorrhagic deaths (65%)</em><em> occurred within 24 hours of admission,</em><em> </em><em>16 of 48</em><em> </em><em>(33%) had a parity of 3 or more,</em><em> 19</em><em> </em><em>(40%) died in ICU and</em><em> 12</em><em> </em><em>(</em><em>25%) in casualty. </em><em>Forty three of 48 women</em><em> </em><em>(</em><em>90%)</em><em> </em><em>were referred</em><em>,</em><em> of which</em><em> </em><em>36</em><em> </em><em>(84%) were from district hospitals. Post-partum haemorrhage accounted for</em><em> </em><em>39 of 48</em><em> </em><em>(81%) deaths followed by unspecifiedante-partum haemorrhage</em><em> accounting for 4 (</em><em>8%)</em><em> </em><em>and placenta abruption 2 of 48 (4%).</em><em></em></p><strong><em>Conclusion</em></strong><em>: This study demonstrated that a maternal death due to obstetric haemorrhage remains a major concern in Limpopo Province. Post-partum haemorrhage was the main cause of deaths.</em>

scholarly journals Obstetric medical care and training in South Africa

2018 ◽  
Vol 12 (1) ◽  
pp. 27-30 ◽  
Author(s):  
Lizemarie Wium ◽  
Valerie Vannevel ◽  
Salome Bothma
Keyword(s):  
South Africa ◽  
South African ◽  
Resource Poor Setting ◽  
National Committee ◽  
Confidential Enquiry ◽  
Maternal Deaths ◽  
Obstetrics And Gynaecology ◽  
Obstetric Medicine ◽  
Prevalence Of Obesity ◽  
And Training

Obstetric medicine as a speciality is yet to be developed in South Africa. South Africa is regarded as a developing country. The burden of HIV and metabolic syndrome creates a need for advanced maternal care. An increase has been noted in hypertension and gestational diabetes due to increasing maternal age and increasing prevalence of obesity. The South African National Committee on Confidential Enquiry into Maternal Deaths’ 2015 Saving Mothers Report identified non-pregnancy-related infections as the leading cause of maternal deaths. Obstetric medicine care includes pre-conception, antepartum and postpartum care. This article aims to highlight the importance of obstetric medicine, even in a resource-poor setting. The current internal medicine and obstetrics and gynaecology training is discussed and emphasis is placed on the opportunity to create an obstetric medicine programme.

scholarly journals Classification of maternal mortality by ICD-MM: a retrospective study from a tertiary care hospital of Chhattisgarh

2021 ◽  
Vol 10 (2) ◽  
pp. 492
Author(s):  
Anju R. Ekka ◽  
Sangeeta R. Jogi
Keyword(s):  
Retrospective Study ◽  
Maternal Mortality ◽  
Cause Of Death ◽  
Maternal Death ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Targeted Interventions ◽  
Hypertensive Disorders ◽  
Obstetric Haemorrhage

Background: Sustainable development goal 3 (SDG 3) includes an ambitious target of reducing the global maternal mortality rate (MMR) to less than 70 per 100 000 births by 2030. To reach this target, countries need an accurate picture of the levels and causes of maternal deaths. A standardization of the cause of death attribution will improve interpretation of data on maternal mortality, analysis on the causes of maternal death, and allocation of resources and programmes intended to address maternal mortality. International classification of diseases-maternal mortality (ICD-MM) has proven to be easily applicable and helps clarify the cause of maternal death.Methods: Retrospective study of 142 maternal death cases was done in a tertiary medical centre (medical college) from December 2017 to November 2020 for determining the causes of maternal death and their classification according to ICD-MM.Results: Direct causes of maternal deaths were observed in 82.39% cases whereas indirect causes were present in remaining 17.61% cases. Hypertensive disorders (35.92%), obstetric haemorrhage (26.06%) and pregnancy related infection (14.79%) constituted the major groups of direct cause of maternal deaths whereas anaemia was the most common indirect cause (7.75%).Conclusions: Hypertensive disorders (35.92%), obstetric haemorrhage (26.06%) and pregnancy related infection (14.79%) were the major causes of direct obstetric death and anaemia (7.75%) was the most common cause of indirect obstetric death. All of these causes are preventable with targeted interventions. Reducing maternal mortality is one of the key targets within the SDG and ICD-MM is a valuable tool for uniform and standard classification of maternal deaths as well as for developing strategies for reducing maternal death. Training on cause of death certification, maternal death surveillance and response (MDSR) documentation and use of ICD is essential to enable consistent application of ICD coding and improve data collection and analysis.

scholarly journals Trends in maternal deaths from epilepsy in the United Kingdom: a 30-year retrospective review

2014 ◽  
Vol 7 (4) ◽  
pp. 160-164 ◽  
Author(s):  
Dipanwita Kapoor ◽  
Suzanne Wallace
Keyword(s):  
United Kingdom ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Retrospective Review ◽  
Neurological Diseases ◽  
Clinical Care ◽  
Confidential Enquiry ◽  
Unexpected Death ◽  
Maternal Deaths ◽  
The Uk

Objective Neurological diseases remain the second most common cause of maternal mortality from indirect causes, according to the last United Kingdom confidential enquiry into maternal death. The maternal mortality rate from epilepsy is reported as 0.61 per 100,000 maternities. The aim of this study was to analyse the trends and causes of maternal death from epilepsy in the UK over the last 30 years. Information on sub-standard care associated with fatalities was also consolidated to inform guidance and clinical care by obstetricians and physicians caring for pregnant women with epilepsy. Study design A retrospective review of 10 triennial confidential enquiry into maternal death reports (1979–2008) was performed, encompassing 21,514,457 maternities. Late and coincidental deaths were not included in the analyses. Results Between 1979 and 2008, there were 92 maternal deaths from epilepsy. The proportion of total maternal deaths from epilepsy over 30 years is 3.7% (95% CI 3.0–4.5), which showed an increasing trend. Sudden unexpected death in epilepsy remains the single greatest cause of maternal death from epilepsy followed by aspiration of gastric contents during seizures and drowning during bathing. Conclusion All women with epilepsy should be looked after by specialist combined obstetric and medical or neurological teams in pregnancy to improve maternal and fetal outcomes.

scholarly journals Occupational Health Risk of Waste Pickers: A Case Study of Northern Region of South Africa

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Solomon E. Uhunamure ◽  
Joshua N. Edokpayi ◽  
Karabo Shale
Keyword(s):  
South Africa ◽  
Occupational Health ◽  
Health Risks ◽  
Low Income ◽  
Statistical Significance ◽  
Limpopo Province ◽  
Cross Sectional Survey ◽  
Validated Questionnaire ◽  
Landfill Sites ◽  
Waste Pickers

In South Africa, waste pickers play a significant role in the management of waste at landfill sites. Waste picking is an income-generating venture for most people with low-income base. The activity of sorting waste at landfill sites is, however, associated with occupational health risks to waste pickers which this study has examined. The study adopted a cross-sectional survey with a convenience sampling method which was conducted among 114 waste pickers in three landfill sites in Limpopo Province of South Africa. A validated questionnaire was used in eliciting responses from the participants. The statistical technique employed includes the ANOVA, simple, and multiple regression. The results indicated that, in the last one year, waste pickers exposed to landfill sites were 1.7 times more likely to develop a common health disorder (AOR: 1.733; 95% CI: 1.069, 2.755; P value: 0.041). There was statistical significance between the number of days worked at the landfill and the health conditions of the waste pickers ( P  ≤ 0.001). The cofounders were adjusted for age and years worked, and the result revealed that days worked by the waste pickers’ increased their chances of occupational health risks by 1.4 times. It is unlikely that waste pickers will have a risk-free environment, but supportive policies such as provision of adequate personal protective equipment and more awareness programmes on the health risks related to such enterprises will aid in abating the associated risks.

scholarly journals Maternal Death Review at a Tertiary Hospital in Ethiopia

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Matiyas Asrat Shiferaw ◽  
Delayehu Bekele ◽  
Feiruz Surur ◽  
Bethel Dereje ◽  
Lemi Belay Tolu
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Tertiary Hospital ◽  
Hypertensive Disorders Of Pregnancy ◽  
Contributing Factors ◽  
Double Burden ◽  
Maternal Deaths ◽  
Hypertensive Disorders ◽  
Mortality Ratio

BACKGROUND፡ There is conflicting data on the rate and trends of maternal mortality in Ethiopia. There is no previous study done on the magnitude and trends of maternal death at Saint Paul's Hospital, an institution providing the largest labor and delivery services in Ethiopia. The objective of this study is to determine the magnitude, causes and contributing factors for maternal deaths in the institution.METHODS: We conducted a retrospective review of maternal deaths from January 2016 to December 2017. Data were analyzed using SPSS version 20.RESULTS: The maternal mortality ratio of the institution was 228.3 per 100,000 live births. Direct maternal death accounted for 90% (n=36) of the deceased. The leading causes of the direct maternal deaths were hypertensive disorders of pregnancy (n=13,32.5%), postpartum hemorrhage (n=10, 25%), sepsis (n=4, 10%), pulmonary thromboembolism (n=3, 7.5%) and amniotic fluid embolism (n=3, 7.5%).CONCLUSION: The maternal mortality ratio was lower than the ratios reported from other institutions in Ethiopia. Hypertensive disorders of pregnancy and malaria were the leading cause of direct and indirect causes of maternal deaths respectively. Embolism has become one of the top causes of maternal death in a rate like the developed nations. This might show the double burden of embolism and other causes of maternal mortality that developing countries might be facing.

scholarly journals The confidential enquiry into maternal deaths in South Africa: a case study

2014 ◽  
Vol 121 ◽  
pp. 53-60 ◽  
Author(s):  
J Moodley ◽  
RC Pattinson ◽  
S Fawcus ◽  
MG Schoon ◽  
N Moran ◽  
...  
Keyword(s):  
South Africa ◽  
Confidential Enquiry ◽  
Maternal Deaths

scholarly journals Prevalence and associated risk factors of hypertension amongst adults in a rural community of Limpopo Province, South Africa

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Samuel T. Ntuli ◽  
Eric Maimela ◽  
Mariannes Alberts ◽  
Solly Choma ◽  
Sekgothe Dikotope
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Rural Community ◽  
Statistical Significance ◽  
Limpopo Province ◽  
World Health ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Health Organization

Background: Hypertension is problem already faced by urban populations of South Africa, but little is known about its prevalence and risk factors in rural areas.Aim: To assess the prevalence of and risk factors associated with hypertension amongst adults in a rural community in South Africa.Setting: Dikgale Health and Demographic Surveillance Site, Limpopo Province, South Africa.Methods: A community-based cross-sectional survey was carried out at this site where individuals aged 15 years and older were screened using a locally adapted version of the World Health Organization STEPwise questionnaire. Demographics, anthropometry and three independent blood pressure (BP) readings were taken. The average of the three BP measurements was used in analysis, and hypertension taken as systolic and diastolic BP of ≥ 140 or ≥ 90 mmHg respectively, or at least a two-week history of antihypertensive treatment. Analysis included the Chi-square test and statistical significance was set at p ≤ 0.05.Results: A total of 1407 individuals were interviewed, of whom 1281 had complete BP, weight and height measurements taken. The mean age of participants was 44.2 ± 2 0.9 years (range 15–98 years), 63% were female, 55% were single and 90% were unemployed, whilst 13% were tobacco smokers and 20% reported drinking alcohol. Overall prevalence of hypertension was 41% and this was significantly associated with age and marital status.Conclusion: The prevalence of hypertension was found to be high. Prevention strategies are urgently needed to address this life-threatening and important risk factor for cardiovascular disease in rural Limpopo Province.

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