scholarly journals Epidemiology and Clinical Features of Maternal Sepsis：A Retrospective Study of Whole Pregnancy Period

2021 ◽  
Author(s):  
Xuan Zhong ◽  
Rongfeng Lin ◽  
Wenni Zhang ◽  
Yiping Luo ◽  
Ding Wang
Keyword(s):  
Epidemiological Study ◽  
Clinical Features ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Fetal Mortality ◽  
Control Group ◽  
Incidence And Mortality ◽  
Mortality Ratio ◽  
Maternal Sepsis ◽  
Poor Outcomes

Abstract Background: Maternal sepsis results in poor outcomes such as fetal or maternal death. The incidence and mortality rates of maternal sepsis are variable in different places because of differences in economic development, race, medical conditions, etc. Identifying the clinical features and determining the possible mechanisms for avoiding morbidity and preventing poor outcomes would benefit committed patients. Therefore, this study was an epidemiological study at a maternity transfer centre in Southeast China that aimed to identify local disease features of maternal sepsis.Methods: This was a local epidemiological study in at a tertiary care center in Guangzhou, China, from 2015 to 2019. A total of 74969 pregnant women experiencing childbirth were included in this study; of these women, 74 patients with maternal sepsis were diagnosed by the sepsis criterion, and 118 patients without sepsis in the same period were selected randomly as the control group to study possible reasons for postpartum sepsis. This experiment covers the whole period from first trimester to puerperium. The clinical data were collected via the hospital electronic medical record system. Single-factor regression and multivariate logistic regression were implemented to analyze the risk factors for maternal sepsis.Results: The incidence of maternal sepsis was 0.099%, the maternal mortality ratio was 0.004% and the fetal mortality ratio was 0.007%. For clinical manifestations, septic shock was associated with a higher severity of patient illness. All of the poor outcomes (maternal or fetal death) occurred during pregnancy. Postpartum sepsis had the longest onset period, and postpartum sepsis was associated with the premature rupture of fetal membranes and preeclampsia.Conclusions: Maternal sepsis is an important cause of both maternal and fetal mortality. Here we described an epidemiological study that evaluated the disease incidence, development and prognosis of local maternal sepsis. Furthermore, the characteristics of maternal sepsis is likely due to unknown pathological mechanisms, and patients would benefit from the identification of more effective treatments for maternal sepsis.

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 Trends and causes of maternal mortality in a tertiary care hospital over five years: 2013-2017

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Sonia Rafiq ◽  
Wajeeha Syed ◽  
Simi Fayaz Ghaffar
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Creative Commons ◽  
Increased Risk ◽  
Mortality Ratio ◽  
Public Health Challenge

Background and Objective: Maternal death measurement is essential to a country’s wellbeing and development status. In emerging countries like Pakistan, it remains an intimidating and failed public health challenge. Objectives of our audit were to estimate trends and causes of maternal demise in Lady Reading Hospital, Peshawar, Pakistan. Methods: Between January 2013 to December 2017, a retrospective study was carried out at Medical Teaching Institute, Lady Reading Hospital, Peshawar. A structured proforma was used to collect data from the medical records. To detect trends in mother demise maternal mortality ratio was calculated for each year and for all five years, Spss version 23 was used for data analysis. Results: In the five-year periods 134 deaths were recorded. The maternal mortality during the study period was 431/100,000 live births. An unstable trend in mortality with two crowning periods in 2013 and 2017 was observed. Hemorrhage persisted as the foremost cause of maternal death over the five years period, accounting for 47.76% deaths followed by hypertension, accounting for 25.37% deaths. An increased risk of 35.08% was observed among women aged 25-29 years, followed by 26.11% in 20-24 years and 23.88% in >30 years. Conclusion: There is a decreasing trend of maternal death from 2013 to 2016 but a slight increase was noted in 2017. Hemorrhage was the top cause responsible for the maternal death. doi: https://doi.org/10.12669/pjms.35.4.1091 How to cite this:Rafiq S, Syed W, Ghaffar SF. Trends and causes of maternal mortality in a tertiary care hospital over five years: 2013-2017. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.1091 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 Maternal death audit at tertiary care centre: changing trends

2021 ◽  
Vol 10 (3) ◽  
pp. 915
Author(s):  
Sudha Sivakumar ◽  
Sophia G. Xavarina ◽  
Ashmitaa Srianand
Keyword(s):  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Epidemiological Data ◽  
Tertiary Care Centre ◽  
Maternal Deaths ◽  
Hospital Department ◽  
Mortality Ratio ◽  
Post Natal Care ◽  
Maternal Death Audit

Background: The aim of the study was to analyse the trend in maternal mortality ratio in a tertiary care centre.Methods: This was a four-year retrospective analysis of maternal deaths that occurred at Government Rajaji Hospital, Department of Obstetrics and Gynaecology, Madurai from January 2017 to December 2020. Cases were stratified based on cause of death. Epidemiological data was collected from the hospital register.Results: The total number of maternal deaths at GRH during the study period is 228, in which death due to obstetric cause was 82 (36%) and non-obstetric cause was 146 (64%). The most common cause in each year was PIH (23%-2017, 29%- 2018), heart disease (22%- 2019) and infection (46%- 2020).Conclusions: We concluded by this study that the maternal death due to non-obstetric causes were more than the obstetric causes due to improved antenatal, post-natal care, institutionalized deliveries and timely referral to the CEmONC (comprehensive emergency obstetric and new-born care) centres and management.

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.

scholarly journals The Addition of Transarterial Chemoembolization to Palliative Chemotherapy Extends Survival in Intrahepatic Cholangiocarcinoma

2021 ◽  
Vol 10 (12) ◽  
pp. 2732
Author(s):  
Simon Johannes Gairing ◽  
Felix Thol ◽  
Lukas Müller ◽  
Felix Hahn ◽  
Thomas Thomaidis ◽  
...  
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Transarterial Chemoembolization ◽  
Palliative Chemotherapy ◽  
Group Performance ◽  
Tertiary Care ◽  
Eastern Cooperative Oncology Group ◽  
Group Versus ◽  
Control Group ◽  
Incidence And Mortality ◽  
Tace Group

Incidence and mortality of intrahepatic cholangiocarcinoma (iCCA) have been increasing continuously. Recent studies suggest that the combination of palliative chemotherapy (pCTX) and transarterial chemoembolization (TACE) improves overall survival (OS). This study aimed to evaluate the outcome of patients treated with TACE and pCTX in unresectable iCCA at our tertiary care center. A group of 14 patients was treated with both pCTX and TACE. The non-randomized control group of 59 patients received pCTX alone. Patients received a median of two pCTX lines in both groups. Those treated with TACE underwent a median number of 3.5 sessions. Median OS from the time of unresectability was 26.2 months in the pCTX + TACE group versus 13.1 months in the pCTX group (p = 0.008). Controlling for albumin, bilirubin, ECOG (Eastern Cooperative Oncology Group) performance status, and UICC (Union for International Cancer Control) stage, the addition of TACE still conferred an OS benefit of 12.95 months (p = 0.014). A propensity score matching analysis yielded an OS benefit of 14 months from the time of unresectability for the pCTX + TACE group (p = 0.020). The addition of TACE to pCTX may provide an OS benefit for patients with unresectable iCCA. Thus, patients with liver-dominant iCCA undergoing standard-of-care pCTX should be considered for additional treatment with TACE.

scholarly journals Analysis of causes of maternal mortality in tertiary care center, 11 years study

2021 ◽  
Vol 10 (9) ◽  
pp. 3320
Author(s):  
Vandana R. Saravade ◽  
Munira Ansari ◽  
Ganesh Shinde
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Care Center ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Hepatitis Infection ◽  
Mortality Ratio ◽  
Late Referral ◽  
Timely Treatment

Background: Objectives to study the causes of maternal mortality and the complications leading to maternal death.Methods: A retrospective study of hospital records and death summaries of all maternal death over a period of 11 years from January 2008 to December 2018 was carried out at tertiary care hospital, Mumbai.Results: There were a total of 459 maternal death out of 36930 live birth giving maternal mortality rate mean maternal mortality ratio (MMR) of 1242 per 100000 live births. Unregistered and late referral account for maternal death. The majority of women were in 21-30 years age group in 20 to less than 37 weeks of pregnancy. The commonest cause of death was due to hepatitis infection 129 (28.1%), sepsis 52 (11.32%), PIH including eclampsia 46 (10.02%), cardiovascular diseases 33 (7.18%), haemorrhage 31 (6.75%), Kochs 31 (6.75%) and respiratory diseases 22 (4.79%).Conclusions: Maternal mortality can be reduced by identifying causes which are preventable and giving timely treatment.

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