TRACKING EXCESS OF MATERNAL DEATHS DIRECTLY AND INDIRECTLY ASSOCIATED WITH COVID-19 IN BRAZIL: A NATIONWIDE DATABASE ANALYSIS

Abstract The COVID-19 pandemic brought a new challenge to maternal mortality in Brazil. Throughout 2020, Brazil registered 549 maternal deaths, mainly concentrated in second and third-trimester pregnant women. We estimate the excess of maternal mortality for Brazil in 2020. Assuming the average number of previous years as expected, or even correcting the expectation for excess female mortality due to COVID-19, we found that maternal mortality was more penalized. We also observed that the difference between the odds of occurrence of symptoms and comorbidities among COVID-19 maternal and female deaths was marginal. Differences between the two groups of deaths are significantly associated with social determination and (in)adequate obstetric care. 2021 has been more severe for maternal mortality. We need to increase immunization and monitoring among pregnant women immediately.

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FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KESEDIAAN IBU BERSALIN UNTUK PEMASANGAN IUD POST PLACENTA

Jurnal Penelitian Kebidanan & Kespro ◽

10.36656/jpk2r.v1i2.143 ◽

2019 ◽

Vol 1 (2) ◽

pp. 28-34

Author(s):

Saiful Batubara ◽

Risqi Utami

Keyword(s):

Maternal Mortality ◽

Pregnant Women ◽

Third Trimester ◽

Chi Square ◽

Purposive Sampling ◽

Factors Associated ◽

Analyze Data

Intra Uterine Device post placenta is the installation in the first 10 minutes to 48 hours after the birth placenta plays a role in reducing maternal mortality through prevention of pregnancy, delaying pregnancy, and spacing pregnancies, the effectiveness of use up to 99.4% can prevent 5-10 years of pregnancy. This study aims to determine the factors associated with maternal willingness to post Post Placenta IUD. The study used a questionnaire with a population of third trimester pregnant women who examined their pregnancies and a sample of 98 people by purposive sampling. Analyze data with Chi Square. The results showed that the majority of pregnant women were not willing to do post placenta IUD installation of 58.2% which was influenced by age, parity, knowledge and support of the husband.

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Maternal mortality during the COVID-19 pandemic in Mexico: a preliminary analysis during the first year

BMC Public Health ◽

10.1186/s12889-021-11325-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nina Mendez-Dominguez ◽

Karen Santos-Zaldívar ◽

Salvador Gomez-Carro ◽

Sudip Datta-Banik ◽

Genny Carrillo

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Maternal Mortality ◽

Respiratory Distress ◽

Pregnant Women ◽

Distress Syndrome ◽

Maternal Mortality Ratio ◽

Maternal Deaths ◽

Immune Impairment ◽

Mortality Ratio

Abstract Background In Mexico, the COVID-19 pandemic led to preventative measures such as confinement and social interaction limitations that paradoxically may have aggravated healthcare access disparities for pregnant women and accentuated health system weaknesses addressing high-risk patients’ pregnancies. Our objective is to estimate the maternal mortality ratio in 1 year and analyze the clinical course of pregnant women hospitalized due to acute respiratory distress syndrome and COVID-19. Methods A retrospective surveillance study of the national maternal mortality was performed from February 2020–February 2021 in Mexico related to COVID-19 cases in pregnant women, including their outcomes. Comparisons were made between patients who died and those who survived to identify prognostic factors and underlying health conditions distribution. Results Maternal Mortality Ratio increased by 56.8% in the studied period, confirmed COVID-19 was the cause of 22.93% of cases. Additionally, unconfirmed cases represented 4.5% of all maternal deaths. Among hospitalized pregnant women with Acute Respiratory Distress Syndrome consistent with COVID-19, smoking and cardiovascular diseases were more common among patients who faced a fatal outcome. They were also more common in the age group of < 19 or > 38. In addition, pneumonia was associated with asthma and immune impairment, while diabetes and increased BMI increased the odds for death (Odds Ratio 2.30 and 1.70, respectively). Conclusions Maternal Mortality Ratio in Mexico increased over 60% in 1 year during the pandemic; COVID-19 was linked to 25.4% of maternal deaths in the studied period. Lethality among pregnant women with a diagnosis of COVID-19 was 2.8%, and while asthma and immune impairment increased propensity for developing pneumonia, obesity and diabetes increased the odds for in-hospital death. Measures are needed to improve access to coordinated well-organized healthcare to reduce maternal deaths related to COVID-19 and pandemic collateral effects.

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Universal Maternal Rights: A Matter of Life and Death

10.21467/preprints.333 ◽

2021 ◽

Author(s):

Alicia Ryan

Keyword(s):

Developing Countries ◽

Maternal Mortality ◽

Obstetric Care ◽

Maternal Deaths ◽

Scientific Methods ◽

Life And Death ◽

The World ◽

Positive Effect ◽

Multiple Obstacles ◽

Maternal Rights

Childbirth has been a part of our lives since the beginning of time. Without the process none of us would be alive today. So why is it that maternal mortality remains one of the greatest inequities in the world? To date, approximately 500, 000 women die annually due to the lack of appropriate prenatal and obstetric care. Difficulties arising with childbirth cannot be predicted. However, the way in which we react to a situation can have a lasting, positive effect on the countries and the women who are at risk. The ways in which to help reduce the large number of maternal deaths in developing countries is not complicated and can be achieved if it is made a priority. In conclusion, there are multiple obstacles in regard to succeeding the highest achievable standard of health globally. With the education of evolving scientific methods, and the collaboration of humanitarian views, the welfare and health of women and their children, can be internationally restored. With the education of evolving scientific methods, and the collaboration of humanitarian views, the welfare and health of women and their children, can be internationally restored.

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Manfaat Rendaman Air Hangat dan Garam dalam Menurunkan Derajat Edema Kaki Ibu Hamil Trimester III

Jurnal SMART Kebidanan ◽

10.34310/sjkb.v7i2.381 ◽

2020 ◽

Vol 7 (2) ◽

pp. 76

Author(s):

Sawitry Sawitry ◽

Fitria Hikmatul Ulya ◽

Elisabet Jemsi Adepatiloy

Keyword(s):

Pregnant Women ◽

Quantitative Research ◽

Mean Value ◽

Lower Limbs ◽

Wilcoxon Test ◽

Warm Water ◽

Third Trimester ◽

Post Test ◽

The Difference ◽

Leg Edema

ABSTRAK Edema kaki terjadi hampir 80% dari semua kehamilan dan dapat menimbulkan ketidaknyamanan selama kehamilan seperti nyeri, merasa berat, kram pada malam hari, penebalan kulit, dan pigmentasi. Salah satu intervensi non farmakologis untuk mengurangi edema adalah rendaman air hangat dan garam yang merupakan intervensi untuk menghilangkan edema pada ekstremitas bawah selama kehamilan. Menganalisis pengaruh rendaman air hangat dan garam terhadap edema kaki ibu hamil trimester III. Penelitian kuantitatif dengan metode quasy eksperimental one group pre test post test desaign. Sampel penelitian sebanyak 16 ibu hamil Trimester III dengan teknik accidental sampling. Analisis data menggunakan uji Wilcoxon. Terjadi penurunan tingkat edema kaki pada ibu hamil dengan selisih nilai tengah edema kaki sebelum 4,00 dan setelah perlakuan sebesar 0,00 .Uji Wilcoxon menunjukkan ρ value 0,000. Ada pengaruh rendaman air hangat dan garam terhadap edema kaki ibu hamil trimester III. Kata Kunci : rendaman air hangat dan garam; edema; tungkai bawah ; ibu hamil. THE EFFECT OF WARM WATER AND SALT IMMERSION IN DECLINING LEG EDEMA OF THIRD TRIMESTER PREGNANT WOMEN ABSTRACT Edema of the legs occurs in almost 80% of all pregnancies and can cause discomfort during pregnancy such as pain, feeling heavy, cramps at night, skin thickening, and pigmentation. One of the non-pharmacological interventions to reduce edema is soaking in warm water and salt which is an intervention to relieve edema in the lower extremities during pregnancy. This study was to determine the effect of warm water and salt immersion in declining leg edema of third trimester pregnant women. This quantitative research used quasy experimental method one group pre test post test desaign. The total samples were 16 respondents with purposive sampling and random sampling techniques. Data analysis used the Wilcoxon test. The difference in the mean value of leg edema before 4.00 and after treatment was 0.00. The Wilcoxon test showed ρ value of 0.000. There is an effect of warm water and salt immersion on leg edema of third trimester pregnant women. Keywords: warm water and salt soaking; edema; lower limbs; pregnant mother

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MATERNAL MORTALITY

The Professional Medical Journal ◽

10.29309/tpmj/2009.16.01.3002 ◽

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.

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The thickness changes of retina in high myopia patients during the third trimester of pregnancy: a pilot study

BMC Ophthalmology ◽

10.1186/s12886-021-02137-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chenchen Liu ◽

Puying Wei ◽

Jun Li

Keyword(s):

Pregnant Women ◽

High Myopia ◽

Retinal Thickness ◽

Control Group ◽

Study Group ◽

Average Thickness ◽

Third Trimester ◽

The Third ◽

The Difference ◽

Control Study

Abstract Objectives To observe and compare the difference in retinal thickness using optical coherence tomography (OCT) between patients with high myopia (HM) during the third trimester of pregnancy and age-matched HM non-pregnant women. Methods A case-control study. A total of 39 eyes from 39 HM women in the third trimester (study group) and 50 eyes of 50 age-matched non-pregnant women with HM (control group) were included. All subjects underwent SD-OCT examination. The built-in software was used to measure the retinal thickness in macular region. The data from two groups were compared using independent-samples t test. Results Among the 89 subjects in this study, the mean gestational age of the study group was 35.09 ± 2.44 weeks, and the average age was 32.24 ± 3.75 years. The average age of the control group was 34.04 ± 7.19 years old. Compared with the control group, the average thickness of parafoveal area, and the average thickness of parafoveal superior, inferior, temporal quadrants of the superficial retina and the average thickness of the foveal and parafoveal of the superficial retina were significantly decreased in the study group (P < 0.05). Compared with the control group, the average thickness of all quadrants of the retina in the parafoveal area except the nasal quadrant were significantly decreased in the study group (P < 0.05). Conclusions In this observational study, the retinal thickness of patients with high myopia during the third trimester of pregnancy was thinner than that of non-pregnant women with age-matched high myopia.

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201217 ◽

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.

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Etiology of Maternal Mortality at Nepalgunj Medical College

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v16i2.24870 ◽

2018 ◽

Vol 16 (2) ◽

pp. 27-30

Author(s):

Durga B.C. ◽

Ganesh Prasad Neupane ◽

Maya Rai ◽

Aseem Sharma

Keyword(s):

Maternal Mortality ◽

Health Care Services ◽

College Teaching ◽

Public Health Problem ◽

Obstetric Care ◽

World Health ◽

Maternal Deaths ◽

Medical College ◽

Surgical Teams ◽

Health Organization

Introduction: Maternal mortality is an indicator of the quality of obstetric care in a community directly reflecting the utilization of health care services available. Maternal mortality has been recognised as a public health problem in the developing countries. Aim and Objective: To analyse the etiology of maternal deaths. Material and Methods: This descriptive study was conducted in the gynaecology and obstetrics department of the Nepalgunj Medical College Teaching Hospital Banke Nepal for a period of two years from august 2016-august 2018. All cases of maternal deaths in line with the definition of World Health Organization have been included. Data were collected and analyzed. Results: Twenty three (23) maternal deaths were identified during the study period. 69.56% of deaths occurred due to direct obstetric causes. Uncontrollable postpartum haemorrhage with 37.5 % was the leading cause of maternal death followed by eclampsia (18.75%) and sepsis (18.75%). Indirect causes were dominated by heart disease. Maximum 56.5% of deaths had occurred after 48 hours of admission. Conclusions: Haemorrhage, eclampsia and infections are the main causes of maternal deaths in our study. access to emergency medication, transfusion and anaesthetic and surgical teams in hospitals but also through the involvement of religious leaders, traditional and any community to better understand the population obstacles to reducing maternal mortality.

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THE DIFFERENCE IN ADDITION OF BACK MASSAGE COMBINATION IN PREGNANCY EXERCISE IN IMPROVING QUALITY OF SLEEP IN THIRD TRIMESTER PREGNANT WOMEN

Majalah Ilmiah Fisioterapi Indonesia ◽

10.24843/mifi.2018.v06.i02.p03 ◽

2018 ◽

Vol 6 (2) ◽

pp. 16

Author(s):

Mezzi Wulandari Arenza ◽

Ni Wayan Tianing ◽

I Putu Adiartha Griadhi

Keyword(s):

Sleep Quality ◽

Pregnant Women ◽

Control Group ◽

Quality Of Sleep ◽

Third Trimester ◽

The Third ◽

The Difference ◽

In Pregnancy ◽

Back Massage

ABSTRACTSleep disturbance in the third trimester pregnant women is caused by discomfort, an increasingly largeabdominal condition, back pain, frequent urination, fetal movement, heartburn, cramps in the legs, tiredness, difficultygetting started, and physiological changes. Sleep disorders result in decreased quality of sleep. Pregnant women whohave poor sleep quality are at risk of longer labor, cesarean delivery, premature birth, and even infant mortality. The aimof this research is to know the difference of pregnant exercise combination and back massage in improving the sleepquality of third trimester pregnant women. This research use experiment method with quasi experiment approach andresearch design is pre and post test with control design. Sample are 18 people, divided into 2 groups, 9 people intreatment groups given pregnancy exercise and back massage and 9 people in control group is given only pregnantexercise. Intervention is given 8 times. Pittsburgh Sleep Quality Index (PSQI) questionnaire used for measured of sleepquality. The result of different test of unpaired group, in the treatment group got difference of average 4,556 and controlgroup got difference mean 2,333 with p=0,004 (p<0,05). These results showed that there was a significant differencebetween the treatment group and the control group in improving the sleep quality of the third trimester pregnant women.In conclusion, there are differences in the addition of back massage combination in pregnancy exercise intervention inimproving sleep quality of third trimester pregnant women.Keyword : Pregnancy Exercise, Back Massage, Sleep Quality, Third Trimester.

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Maternal mortality and its relationship to emergency obstetric care (EmOC) in a tertiary care hospital in South India

Obstetric Medicine ◽

10.1177/1753495x15575949 ◽

2015 ◽

Vol 8 (2) ◽

pp. 86-91 ◽

Cited By ~ 1

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.

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