Maternal mortality: A 10-year study at Nishtar Hospital Multan

Objective: To analyse causes of maternal deaths and to identify preventable causes leading to this tragedy in our setup. Design: An analytical, hospital-based study. Place and duration of study: Department of Obstetric and Gynaecology, Nishter Hospital Multan from June-August 2005. Patients and methods: During the study period retrospective data was collected for period of 10 year from January 1995 to December 2004. This data was analyzed in order to determine the Maternal Mortality Rate (MMR), causes of death and characteristics of the mothers who died including her age, parity and whether they were booked or unbooked. Results: A total numbers of 30031 deliveries took place during the study period and there were 178 maternal deaths with maternal mortality rate of 593/100,000 LB (live births). 7(3.9%) patients were below the age of 20, 74(41.5%) were in the age group of 21-30 and 82(46%) in 31-40 years age range. 15(8.42%) were above the age of 40. Most of them (69%) were grand multiparas (Parity >5). The major causative factors were haemorrhage 63(35.4%), eclampsia 41(23.03%), sepsis 25(14.04%), anaemia 18(10.1%), hepatic encephalopathy 14(7.9%), abortion 11(6.2%). Majority of the patients were unbooked and presented in the hospital very late. Conclusion: A high proportion of potentially preventable maternal deaths indicate the need for improvements in education for both patient and health care provider. The provision of skilled care and timely management of complications can lower maternal mortality in our setup.

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Two year review of maternal mortality at a tertiary care hospital of GMERS, Valsad, Gujarat, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182336 ◽

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.

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Mengenal Tanda-Tanda Bahaya Kehamilan di Puskesmas Pakuan Baru Kota Jambi

Jurnal Abdimas Kesehatan (JAK) ◽

10.36565/jak.v3i1.150 ◽

2021 ◽

Vol 3 (1) ◽

pp. 52

Author(s):

Ria Febrina

Keyword(s):

Mortality Rate ◽

Maternal Mortality ◽

Pregnant Women ◽

Community Service ◽

Health Workers ◽

Obstetric Complications ◽

Maternal Deaths ◽

Maternal Mortality Rate ◽

Live Births ◽

Danger Signs

Maternal Mortality Rate (MMR) in Indonesia is still high compared to other ASEAN countries. MMR in Indonesia according to the 2017 Indonesian Demographic and Health Survey (IDHS) is 305 per 100,000 live births. The global target of SDGs (Suitainable Development Goals) is to reduce the Maternal Mortality Rate (MMR) to 70 per 100,000 live births. While in Jambi Province in 2017 recorded maternal deaths were 29 cases. Maternal deaths that occur during 90% of pregnancy are caused by obstetric complications. Direct obstetric complications are bleeding, infection and eclampsia. Indirectly maternal mortality is also influenced by delays at the family level in recognizing danger signs of pregnancy and making decisions to immediately seek help. Delay in reaching health facilities and assistance in health service facilities. Pregnancy danger signs must be recognized and detected early so that they can be handled properly because any danger signs of pregnancy can lead to pregnancy complications. Therefore it is necessary to provide counseling to improve the knowledge of pregnant women about the danger signs of pregnancy. This community service activity was carried out by Pakuan Baru Kota Jambi Public Health Center. The time of implementation in April 2020. The target is pregnant women. Community service methods include a survey and lecture approach. The results obtained are pregnant women able to understand the danger signs of pregnancy. It is recommended for health workers to continue to provide education related to pregnancy to pregnant women

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Maternal mortality rate in Bao'an district, Shenzhen, China, 1999-2018

10.21203/rs.3.rs-76739/v1 ◽

2020 ◽

Author(s):

yuanfang zhu ◽

Yali Luo ◽

Wei Wang ◽

Liling Wang ◽

Yuli Cheng ◽

...

Keyword(s):

Mortality Rate ◽

Maternal Mortality ◽

Health Management ◽

Maternal Deaths ◽

Maternal Mortality Rate ◽

Targeted Interventions ◽

Live Births ◽

Fast Decline ◽

Rate Of Decline ◽

Substantial Heterogeneity

Abstract Background China had achieved impressive success in reducing maternal mortality rate (MMR), while substantial heterogeneity still existed, and reports from Shenzhen region remained a blank. This study aiming to use all available data sources to evaluate the MMR from 1999 to 2018 in Bao’an district, Shenzhen, China. Methods Data on maternal deaths and key health-service-related indicators were obtained from registration forms and Shenzhen Maternal and Child Health Management System. The levels and trends of MMR, profiles and leading causes of death, as well as results from the maternal mortality review committee were analyzed. Results The MMR in Bao’an district declined from 95.31 per 100,000 live births in 1999 to zero in 2018, with an annualized rate of decline of 12.03% per year. A significant declining trend of MMR was observed over 5-year intervals (from 82.61 to 5.22 per 100,000 live births). MMR was higher among migrant population, women aged ≥ 35 years or those who given birth outside the hospital. The first three causes of maternal death included hemorrhage (27.69%), amniotic fluid embolism (22.31%) and internal medical disease complications (15.38%). Nearly ninety percent (86.78%) of maternal deaths were determined to be preventable. Conclusions Bao’an district had experienced a fast decline in MMR for a two-decade period, its experience in lowering MMR could provide a guideline for other regions to focus on those who needed particular attention and take targeted interventions to reduce maternal deaths.

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The assessment of maternal deaths between 2015 and 2020 in Elazığ, Turkey

Perinatal Journal ◽

10.2399/prn.20.0283008 ◽

2020 ◽

Vol 28 (3) ◽

pp. 183-189

Author(s):

İbrahim Batmaz ◽

Salih Burçin Kavak ◽

Ebru Çelik Kavak ◽

Evrim Gül ◽

Cengiz Şanlı ◽

...

Keyword(s):

Mortality Rate ◽

Maternal Mortality ◽

Maternal Death ◽

Public Health Issue ◽

Family Practitioner ◽

Delay Model ◽

Maternal Deaths ◽

Maternal Mortality Rate ◽

Live Births ◽

Death Cases

Objective: To determine the maternal deaths and the factors affecting them in our city. Methods: The maternal deaths occurred in our city between January 2015 and June 2020 were reviewed retrospectively. The review was conducted by checking “Maternal Death Registry Forms” of the Provincial Directorate of Health. In cases where additional data related with the cause of death were required, the relatives of the cases, associated family practitioner, The Council of Forensic Medicine or local authorities were contacted. The data of the cases including age, gravida, parity, abortion, delivery type, week of gestation during delivery, period of death and maternal deaths due to direct, indirect and incidental causes were recorded. Based on total live births and maternal deaths within 6.5 years, maternal mortality rate was found as the maternal death number per 100,000 live births. Descriptive statistics were used for the statistical analysis of the data. Results: A total of 46.618 live births occurred between 2015 and 2020 in Elazığ. The number of maternal deaths due to direct and indirect causes is 7, and maternal mortality rate was found 15.01/100,000. Hypertensive diseases during pregnancy (n=3, 42.8%), pulmonary embolism (n=1, 14.3%) and cerebral thrombosis (n=1, 14.3%) were among the natural causes of maternal deaths. Indirect cause for maternal death was cardiac diseases (n=2, 28.6%). When they were categorized according to the Three Delays Model, there were 3 death cases in the first delay model and 2 death cases in the third delay model, but there was no maternal death in the second delay model. Conclusion: Maternal death is an significant public health issue which develops due to the generally preventable causes and maintains its importance. The factors contributing to death should be paid attention in order to decrease maternal death rates.

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Maternalmortality in Benghazi: a clinicoepidemiological study

Eastern Mediterranean Health Journal ◽

10.26719/2000.6.2-3.283 ◽

2000 ◽

Vol 6 (2-3) ◽

pp. 283-293

Author(s):

M. Legnain ◽

R. Singh ◽

M. O. Busarira

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Mortality Rate ◽

Birth Interval ◽

Causes Of Death ◽

Surgical Intervention ◽

Hypertensive Disease ◽

Maternal Deaths ◽

Live Births ◽

Almost All

We conducted a clinicoepidemiological study of 14 maternal deaths out of 79 981 live births at Al-Jamahiriya Hospital, Benghazi between 1993 and 1997. The maternal mortality rate per 100 000 live births was 17.5. The reproductive profile of these women was: mean age 31.5 +/- 6.9 years, mean parity 4.5, mean birth interval 14.6 +/- 7.0 months, mean gestation 27.7 +/- 14.6 weeks and mean haemoglobin 9.3 +/- 2.1 g/dL. None of the women had prebooked their delivery, 50% had preconceptional medical or obstetric risk factors, around 70% were anaemic, almost all were admitted with serious medical conditions and > 50% required surgical intervention. The main underlying medical causes of death were: hypertensive disease of pregnancy [28.6%], haemorrhage [14.3%], pulmonary embolism [14.3%]and brain tumour [14.3%]

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Gambaran kematian maternal di RSUP Prof. Dr. R. D. Kandou Manado 1 Januari 2013 – 31 Desember 2015

e-CliniC ◽

10.35790/ecl.4.2.2016.14595 ◽

2016 ◽

Vol 4 (2) ◽

Author(s):

Mustika S. Lumbanraja ◽

Hermie M.M. Tendean ◽

Maria Loho

Keyword(s):

Mortality Rate ◽

Maternal Mortality ◽

Maternal Death ◽

Age Group ◽

Health Issues ◽

Maternal Deaths ◽

Working Mother ◽

The Status ◽

Using Data ◽

And Child Health

Abstract: Maternal death is the death of a pregnant woman or death within 42 days after the termination of pregnancy, irrespective of the length and location of the pregnancy, caused by anything related to pregnancy, or aggravated by the pregnancy or its handling, but not the death caused by accident or accidentally. Maternal mortality is one of the indicators to evaluate the progress of the health of a country, especially those related to maternal and child health issues. This study was aimed to determine the characteristics of maternal death. This was a descriptive retrospective study using data of the Medical Record Department of Prof. Dr. R. D. Kandou Manado from 1 January 2013 to 31 December 2015. In this study, there were 41 cases of maternal deaths. In 2013 and 2014, the highest death rate was in the age group >35 years, while in 2015 in the age group 20-25 years. Based on the number of parity, the highest mortality rates in the number of parity 2-3 in 2013 and 2014, while in 2015 the number of parity ≤1. The highest mortality rate by level of education was high school educated. Based on employment status, the highest mortality rate was in the group of working mother. The highest death toll was based on marital status in the group who are married. Based on the status of the referral highest mortality rate was in status is not a referral. This study found that the highest cause of maternal mortality is three consecutive years eclampsia, sepsis, eclampsia. Conclusion: Of 41 cases of maternal deaths in the Department of Prof. Dr. R. D. Kandou Manado for 3 years, the most cause of death was due to eclampsia/pre-eclampsia which was 4-7 cases each year. Maternal mortality rate per 100000 live births yearly in sequence were 373, 427, 789.Keywords: maternal death Abstrak: Kematian maternal adalah kematian wanita yang terjadi saat hamil atau dalam 42 hari setelah berakhirnya kehamilan, tidak tergantung dari lama dan lokasi kehamilan, disebabkan oleh apapun yang berhubungan dengan kehamilan, atau yang diperberat oleh kehamilan tersebut atau penanganannya, tetapi bukan kematian yang disebabkan oleh kecelakaan atau kebetulan. Kematian maternal merupakan salah satu indikator untuk melihat kemajuan kesehatan suatu negara, khususnya yang berkaitan dengan masalah kesehatan ibu dan anak. Penelitian ini bertujuan untuk mengetahui gambaran kematian maternal. Jenis penelitian ini ialah deskriptif retrospektif menggunakan rekam medik di RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari 2013-31 Desember 2015. Pada penelitian ini, ditemukan 42 kasus kematian maternal. Pada tahun 2013 dan 2014 angka kematian tertinggi di kelompok usia >35 tahun, sedangkan tahun 2015 ditemukan di kelompok usia 20-25 tahun. Berdasarkan jumlah paritas, angka kematian tertinggi pada jumlah paritas 2-3 di tahun 2013 dan 2014, sedangkan untuk tahun 2015 pada jumlah paritas ≤1. Angka kematian tertinggi berdasarkan tingkat pendidikan ialah SMA. Berdasarkan status pekerjaan, angka kematian tertinggi berada pada kelompok ibu yang bekerja. Angka kematian tertinggi berdasarkan status pernikahan berada pada kelompok yang sudah menikah. Berdasarkan status rujukan angka kematian yang tertinggi ialah pada status bukan rujukan. Pada penelitian ini ditemukan penyebab kematian ibu yang tertinggi 3 tahun berurutan ialah pre-eklampsia/eklampsia, infeksi, pre-eklampsia/eklampsia. Simpulan: Jumlah kematian maternal di RSUP Prof. Dr. R. D. Kandou Manado selama 3 tahun yaitu sebanyak 41 kasus. Penyebab kematian terbanyak disebabkan oleh eklampsia/pre-eklampsia yaitu 4-7 kasus per tahun. Angka kematian ibu per 100000 kelahiran hidup per tahun berurutan ialah 373, 427, 789. Kata kunci: kematian maternal

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Temporal Evolution of Maternal Mortality: 1980-2019

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0041-1735300 ◽

2021 ◽

Vol 43 (09) ◽

pp. 662-668

Author(s):

Janete Vettorazzi ◽

Edimárlei Gonsales Valério ◽

Maria Alexandrina Zanatta ◽

Mariana Hollmann Scheffler ◽

Sergio Hofmeister de Almeida Martins Costa ◽

...

Keyword(s):

Maternal Mortality ◽

Medical Records ◽

Causes Of Death ◽

Maternal Mortality Ratio ◽

Liver Steatosis ◽

Reproductive Age ◽

Porto Alegre ◽

Maternal Deaths ◽

Live Births ◽

Mortality Ratio

Abstract Objective To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution. Methods Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327). Results After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%). Conclusion Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.

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Historical and Recent Changes in Maternal Mortality Due to Hypertensive Disorders in the United States, 1979 to 2018

Hypertension ◽

10.1161/hypertensionaha.121.17661 ◽

2021 ◽

Vol 78 (5) ◽

pp. 1414-1422

Author(s):

Cande V. Ananth ◽

Justin S. Brandt ◽

Jennifer Hill ◽

Hillary L. Graham ◽

Sonal Grover ◽

...

Keyword(s):

United States ◽

Mortality Rate ◽

Maternal Mortality ◽

Birth Cohort ◽

White Women ◽

Gestational Hypertension ◽

The United States ◽

Chronic Hypertension ◽

Maternal Deaths ◽

Live Births

We evaluated the contributions of maternal age, year of death (period), and year of birth (cohort) on trends in hypertension-related maternal deaths in the United States. We undertook a sequential time series analysis of 155 710 441 live births and 3287 hypertension-related maternal deaths in the United States, 1979 to 2018. Trends in pregnancy-related mortality rate (maternal mortality rate [MMR]) due to chronic hypertension, gestational hypertension, and preeclampsia/eclampsia, were examined. MMR was defined as death during pregnancy or within 42 days postpartum due to hypertension. Trends in overall and race-specific hypertension-related MMR based on age, period, and birth cohort were evaluated based on weighted Poisson models. Trends were also adjusted for secular changes in obesity rates and corrected for potential death misclassification. During the 40-year period, the overall hypertension-related MMR was 2.1 per 100 000 live births, with MMR being almost 4-fold higher among Black compared with White women (5.4 [n=1396] versus 1.4 [n=1747] per 100 000 live births). Advancing age was associated with a sharp increase in MMR at ≥15 years among Black women and at ≥25 years among White women. Birth cohort was also associated with increasing MMR. Preeclampsia/eclampsia-related MMR declined annually by 2.6% (95% CI, 2.2–2.9), but chronic hypertension–related MMR increased annually by 9.2% (95% CI, 7.9–10.6). The decline in MMR was attenuated when adjusted for increasing obesity rates. The temporal burden of hypertension-related MMR in the United States has increased substantially for chronic hypertension–associated MMR and decreased for preeclampsia/eclampsia-associated MMR. Nevertheless, deaths from hypertension continue to contribute substantially to maternal deaths.

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Mapping maternal mortality rate via spatial zero-inflated models for count data: A case study of facility-based maternal deaths from Mozambique

PLoS ONE ◽

10.1371/journal.pone.0202186 ◽

2018 ◽

Vol 13 (11) ◽

pp. e0202186 ◽

Cited By ~ 2

Author(s):

Osvaldo Loquiha ◽

Niel Hens ◽

Leonardo Chavane ◽

Marleen Temmerman ◽

Nafissa Osman ◽

...

Keyword(s):

Mortality Rate ◽

Maternal Mortality ◽

Count Data ◽

Maternal Deaths ◽

Maternal Mortality Rate

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A study of maternal mortality and midwifery on the Isle of Man, 1882 to 1961

Medical History ◽

10.1017/s0025727300060981 ◽

1996 ◽

Vol 40 (2) ◽

pp. 141-172 ◽

Cited By ~ 7

Author(s):

C G Pantin

Keyword(s):

Mortality Rate ◽

Maternal Mortality ◽

Maternal Deaths ◽

Family Doctors ◽

Maternal Mortality Rate ◽

Isle Of Man ◽

The Family ◽

Labour Room ◽

Maternity Home ◽

Skilled Staff

The living conditions and the health of Manx mothers continued to improve from 1881 to 1961. Against this background they were at first delivered conservatively and mostly by midwives. During this conservative phase the proportion of mothers surviving childbirth increased as their health improved: by the quinquennium 1907–1911 the maternal mortality rate on the Island was half what it had been twenty years earlier. Between 1912 and 1927 maternal mortality rose and during the quinquennium 1922–1926 the MD/BR was again at the level it had been thirty years before. Some of the maternal deaths during the quinquennium were among women who were subjected to intervention during childbirth by doctors in the unfavourable surroundings of their homes; conditions more suited to delivery by the conservative methods of kindly and patient handywomen. Following the opening of a small maternity home on 6 May 1927 the family doctors began to send their difficult deliveries into the Home where they were looked after by skilled staff and delivered in a well–equipped labour room. Throughout the subsequent decade the MD/BR remained at a level below that in 1907–1911.

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