scholarly journals Pattern of Severe Acute Maternal Morbidity in a Tertiary Care Institute

2016 ◽  
Vol 3 (2) ◽  
pp. 45
Author(s):  
Narinder Kaur ◽  
Shreyashi Aryal
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
College Teaching ◽  
Maternal Health Care ◽  
Near Miss ◽  
Eligibility Criteria ◽  
Severe Acute Maternal Morbidity

Introduction: Maternal mortality traditionally has been the indicator of maternal health all over the world. More recently review of the cases of severe acute maternal morbidity (SAMM), also termed as "near miss obstetrics events", has been found to be a useful supplementary indicator to investigate maternal health care. Cases of near miss are those in which women present with potentially fatal complication during pregnancy, delivery, or the puerperium and survive merely by chance or by good hospital care. This study was done with the objective to analyze cases of SAMM at Lumbini Medical College Teaching Hospital (LMCTH), Nepal.   Methods:   A retrospective study of all cases meeting the WHO criteria for SAMM,  during May 2015, was done. Cases meeting the WHO eligibility criteria for near miss cases were included in the study. Medical record of such cases in past one year was reviewed. Their socio-demographic variables, parity, gestational age, associated organ dysfunction, ICU and hospital stay, management, and fetal and maternal outcome were noted.   Results: During the study period, there were total of 28 cases of SAMM and two maternal mortality out of 2735 live births. Thus rate of SAMM was 1.02%, and maternal mortality rate was 0.07%. Majority of patients were unbooked (n=18, 64.28%) and 10 (35.71%) were illiterate. Commonest causes for admission to ICU was hemorrhage (n=10, 35.71%) followed by hypertensive disorders (n=9, 32.06%), sepsis (n=2, 7.14%), and obstructed labour (n=2, 7.14%). Laparotomy was performed in six (21.42%) women, obstetric hysterectomy in four (14.28%), and pelvic devascularization in two (10.71%).   Conclusion: SAMM is a useful adjunct to maternal mortality to assess maternal health care. Improving facility based care and prompt referral, education of primary health care (PHC) staff can be a short term measure to quickly reduce the number of maternal deaths. Facility based monitoring and reporting of SAMM outcome is an important step for scaling up such efforts.

scholarly journals Maternal near miss review: a brief appraisal

2017 ◽  
Vol 6 (5) ◽  
pp. 1703 ◽  
Author(s):  
Sheeba Marwah ◽  
Manjula Sharma
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Maternal Morbidity ◽  
Health Care Services ◽  
Maternal Mortality Ratio ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Care Services ◽  
Mortality Ratio

Recuperation of maternal health is mandatory for realms signatory to millennium declaration, as MDG 5A aims at reduction in maternal mortality ratio by three quarters between 1990 and 2015. MM is frequently described as “Just the Tip of The Iceberg” with a vast base of maternal morbidity that still remains largely undescribed. Hence, the concept of maternal near miss (MNM) or severe acute maternal Morbidity (SAMM) was instituted in maternal health care to complement information acquired from MDR. Here we present a succinct review to enlighten and update the readers about the concept of maternal near miss and its advantage in providing the modern-day obstetricians and the administrators an edge over maternal mortality in gauging the quality of health care delivered at each facility. This would thus be instrumental in helping them formulating policies to enhance the health care services at each level across the nation.

scholarly journals A cross sectional study on severe acute maternal morbidity near-miss at tertiary care centre in Hyderabad, Telangana, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1761
Author(s):  
Mahesh Kumar Mummadi ◽  
Sowmya Javvaji
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Near Miss ◽  
World Health ◽  
Maternal Near Miss ◽  
Severe Acute Maternal Morbidity ◽  
Life Threatening

Background: A maternal near-miss case is defined by World Health Organization (WHO) as “a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.” Severe acute maternal morbidity (SAMM) is the acronym for the more popular term of ‘near-miss’ cases. There are approximately 118 life threatening events of “near miss mortality” or SAMM for each maternal death. Analysing near miss cases can prevent maternal death.Methods: It is a retrospective study based on medical records. Sample size is all the pregnant cases admitted in Department of Obstetrics and Gynecology in AIMSR, Hyderabad, Telangana, India over the period of January 2015- June 2017 (two and half years) i.e. 2276. All records were gathered and each record that satisfy near miss criteria/maternal mortality were segregated, data has been collected on the occurrence of severe pregnancy-related complications or those who require critical interventions and admission to intensive care unit as per the proforma (according to WHO near miss questionnaire). Data entry done in MS Excel and analyzed using Epi Info.Results: Total MNM/SAMM patients were 85 out of 2276 pregnant women (3.7%). The duration of the stay, potential life-threatening conditions (PTLC), critical interventions, organ dysfunctions, mode of delivery, treatment for PPH, hypertensive disorders and associated conditions among SAMM patients were calculated. SAMM patients who has severe post-partum hemorrhage PPH were 24.7%, severe pre-eclampsia was 31.7%, eclampsia was 2.4%, patients with both severe PPH and eclampsia were 2.4%.Conclusions: Near misses can be prevented to some extent by spreading awareness about possible obstetric complications and risk stratification. The WHO tool for analysis of maternal near miss or SAMM can identify more preventable causes of maternal death. Prospective monitoring of maternal morbidity may be useful in identifying determinants of severe maternal mortality.

scholarly journals A prospective study on awareness of postnatal mothers regarding self and newborn care in a tertiary care centre in Mangalore, Karnataka

2020 ◽  
Vol 10 (1) ◽  
pp. 239
Author(s):  
Pradeep Ganiga ◽  
Sourabha S. Shetty
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Postnatal Care ◽  
Tertiary Care ◽  
Newborn Care ◽  
Maternal Health Care ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Postnatal Women ◽  
Postnatal Mothers

Background: Postnatal care is the important portion of maternal health care as it helps to assess the health status of mother and newborn. It promotes to rectify the defect and to identify the progress of the baby that is essential to solve the health issues.Methods: All 100 postnatal women were assessed regarding awareness of self and newborn care using structured questionnaire.Results: In this study maximum number were in age group of 21-25 years (42%). Majority of respondents were literate (88%). Main source of information regarding postnatal and neonatal care is given by health care personnel (49%). 77% cleaned the perineum after defecation and urination. 39% of postnatal mothers practice postnatal exercise. 54% were aware of spacing between two pregnancies. Majority of mothers agreed that colostrum is first breast milk and are aware on giving it to newborn (68%). 78% are aware of exclusively breast feeding baby for 6 months. 79% of postnatal women were aware vaccines prevent diseases in baby. Postnatal mothers had good awareness about self and newborn care.Conclusions: The first 48 hours after delivery is the time when the mother and baby are most vulnerable to morbidity and mortality associated with childbirth. Postnatal care is one of the most important maternal health care for not only prevention of impairment and disabilities, but also for reduction of maternal and neonatal mortality and morbidity.

Influence of Social and Cultural Practices on Maternal Mortality: A Qualitative Study from South Punjab, Pakistan

2020 ◽  
Author(s):  
Sonia Omer ◽  
Rubeena Zakar ◽  
Muhammad Zakria Zakar ◽  
Florian Fischer
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Maternal Care ◽  
Cultural Practices ◽  
Cultural Factors ◽  
Maternal Health Care ◽  
High Rate ◽  
Maternal Deaths ◽  
Social And Cultural Factors

Abstract Background: A disproportionate high rate of maternal deaths are reported in developing and underdeveloped regions of the world. Much is associated with social and cultural factors which are barriers for women to utilise appropriate maternal health care. A huge body of research is available on maternal mortality in developing countries. Nevertheless, there is paucity of literature on socio-cultural factors leading to maternal mortality within the context of the Three Delay Model. The current study aims to explore socio-cultural factors leading to a delay in seeking care in maternal healthcare in South Punjab, Pakistan. Methods: We used a qualitative method and performed three types of data collection with different target groups: i) 60 key informative interviews with gynaecologists, ii) four focus group discussions with Lady Health Workers (LHWs), and iii) ten case studies among family members of deceased mothers. The study was conducted in Dear Ghazi Khan, situated at South Punjab, Pakistan. Data was analysed with the help of thematic analysis.Results: The study identified that delay in seeking care – and its potentially following maternal mortality – is more likely to occur due to certain social and cultural factors in Pakistan. Poor socioeconomic status, limited knowledge on maternal care, and financial constraints of rural people were the main barriers in seeking care. Low status of women and male domination keeps women less empowered. The preference of traditional birth attendants results into maternal deaths. In addition to that, early marriages and lack of family planning as deeply entrenched in cultural values, religion and traditions – e.g. the influence of spiritual healers – prevented young girls to obtain maternal health care.Conclusion: The situation of maternal mortality is highly alarming in Pakistan. The uphill task of reducing deaths among pregnant women is deeply rooted in addressing certain socio-cultural practices, which are constraints for women seeking maternal care. The focus on reduction of poverty and enhancement of decision-making power is essential for approaching the right of medical care.

scholarly journals Study of the cases of severe acute maternal morbidity at a tertiary care centre

2018 ◽  
Vol 7 (5) ◽  
pp. 1852
Author(s):  
Shehla Jamal ◽  
Ruchi Srivastava ◽  
Arpit Jain ◽  
Nimmi Chutani ◽  
Shelly Agarwal ◽  
...  
Keyword(s):  
Maternal Morbidity ◽  
Tertiary Care ◽  
Near Miss ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Maternal Deaths ◽  
Live Births ◽  
Severe Acute Maternal Morbidity ◽  
Mortality Index ◽  
Study Results

Background: Reduction in the maternal morbidity has been the key strategy towards achievement of Millennium Development Goal. Despite exhaustive measures at all levels, the decline has been slow. WHO in 2007 established a technical working group to identify cases of severe acute maternal morbidity. It served dual goals to identify the causes and pointing out delays leading to SAMM. SAMM is now an established superior indicator of surviving women’s health and allows uniform comparisons. The present study was conducted with an aim to identify cases of SAMM at our centre. The objective is to determine the frequency of maternal near miss and conduct an epidemiological survey.Methods: This retrospective study was conducted in the department of Obstetrics and Gynecology and ICU of School of Medical Sciences and Research, Greater Noida, from November 2014 to October 2017. All the cases identified as SAMM, as per WHO 2009 criteria (modified according to the local protocol), were included in the study.  Results: During the study period there were a total of 2252 delivery, out of which 2051 were live births. There were 123 SAMM cases and 47 were excluded out of study. So, study was done on 76 cases of SAMM, and on 11 maternal deaths in the study period. Calculated MNM incidence ratio was 37.05 per 1000 live births. A mortality index of 12.64% was calculated. MNM to maternal death ratio was 6.9:1. Major identifiable cause for SAMM was hypertension (35.5%)), followed by haemorrhage (18.4%). Haematologic system was the commonest organ system involved. 67.8% of the admissions were done in critical condition.Conclusions: Maternal mortality and SAMM cases shared characteristics, and study of SAMM cases can provide an insight into the causative etiology and give time for early intervention.

scholarly journals Utilization of maternal health care services in slum areas of Dhaka city, Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 44-48
Author(s):  
Housne Ara Begum ◽  
Nilufar Yeasmin Nili ◽  
Amir Mohammad Sayem
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Health Care Services ◽  
Maternal Health Care ◽  
Dhaka City ◽  
Care Services ◽  
Maternal Health Care Services ◽  
Socio Economic Variables ◽  
Slum Areas

Bangladesh has one of the highest maternal mortality rates (MMR) in the world. The estimated lifetime risk of dying from pregnancy and childbirth related causes in Bangladesh is about 100 times higher compare to developed countries. However, utilization of maternal health care services (MHCS) is notably low. This study examines the socio-economic determinants of utilization of MHCS in some slum areas of Dhaka city. The overall utilization was 86.3% of women; however, utilization of different sorts of MHCS was very low, i.e., the mean utilization was found to be 2.25 out of 5 MHCS. Indicator wise, ANC, TT, institutional delivery, delivery assistance by health professional and PNC were received by 61.3%, 80.4%, 12.6%, 33.2% and 55.4% of women respectively. Variation was observed with different socio-economic variables. Multiple regression model could explain 38% of variance (P<0.001). Among the significant determinants, order of last birth negatively explained the most variance (15.2%). Similarly, distance between home and clinic was found to affect the utilization negatively. Besides, some respondents’ socio economic variables had a significant positive effect on MHCS utilization. To reduce maternal mortality in disadvantaged women in slum areas, this study might suggest a few pointers while considering formulation of policies and planning. Keywords: determinants; utilization; maternal health care; service; slum areas DOI: 10.3329/imcj.v4i2.6495Ibrahim Med. Coll. J. 2010; 4(2): 44-48

scholarly journals Overview of equity in maternal health care coverage by ethnicity

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N Armenta-Paulino ◽  
M Sandín Vázquez ◽  
F Bolúmar
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Skilled Birth Attendant ◽  
Maternal Health Care ◽  
Indigenous Women ◽  
Vulnerable Groups ◽  
Cross Sectional ◽  
Health Care Coverage ◽  
The Continuum

Abstract Background Indigenous women are one of the most vulnerable groups in Latin America. They experience substantially worse maternal health outcomes than most of the population and less likely to benefit from services. Therefore, inequities in maternal health care between different ethnic groups should be monitored to identify critical factors that could limit health care coverage. Methods Cross-sectional analysis of the continuum of maternal health care, the indicators covering the continuum of women's care from pregnancy to the puerperium were estimated. We used nationally representative demographic surveys from Bolivia, Guatemala, Mexico, and Peru (2008-2016) to explore the coverage gaps across maternal health care by ethnicity. Women were classified as indigenous through self-identification, and we measured a relative inequality by ethnicity through the estimation of adjusted coverage ratios (CR), CR = 1 means that the coverage is equal between indigenous and non-indigenous. We estimated the CR with Poisson regression models adjusted for sociodemographic variables. Results Indigenous women in all four countries had less coverage than non-indigenous in the continuum of maternal healthcare. The most relevant inequalities occur in the coverage of skilled-birth-attendant and in the use of contraceptives, mainly for Bolivia [CR = 0.64, p &lt; 0.001; CR = 0.91, p &lt; 0.001] and Guatemala [CR = 0.78, p &lt; 0.001; 0.77 (0.73;0.80), p &lt; 0.001]. Peru and Mexico are the countries with the smallest gaps throughout the continuum care and Guatemala with the largest. Conclusions The differences observed reflect the inequities that indigenous women face in the coverage of maternal health care. Therefore, it is useful and necessary to monitor ethnicity inequalities to identify the factors that limit the coverage of care that indigenous women receive to design culturally appropriate programs and policies to reduce the risks of maternal mortality and the inequities in care that indigenous women face. Key messages As long as the inequalities persist, identifying them will be the first step in their elimination. If not reduce the differences in care, it will be difficult to reduce maternal mortality that indigenous women face.

scholarly journals Maternal Mortality and Maternal Health Care in Nigeria: Implications for Socio-Economic Development

2019 ◽  
Vol 7 (5) ◽  
pp. 849-855 ◽  
Author(s):  
Olawale Olonade ◽  
Tomike I. Olawande ◽  
Oluwatobi Joseph Alabi ◽  
David Imhonopi
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Health Care System ◽  
Socioeconomic Development ◽  
Maternal Health Care ◽  
African Countries ◽  
Sub Saharan ◽  
The Government ◽  
Care System

BACKGROUND: Even though maternal mortality, which is a pregnancy-related death is preventable, it has continued to increase in many nations of the world, especially in the African countries of the sub-Saharan regions caused by factors which include a low level of socioeconomic development. AIM: This paper focuses on cogent issues affecting maternal mortality by unpacking its precipitating factors and examining the maternal health care system in Nigeria. METHODS: Contemporary works of literature were reviewed, and the functionalist perspective served as a theoretical guide to examine the interrelated functions of several sectors of the society to the outcome of maternal mortality. RESULTS: It was noted that apart from the medical related causes (direct and indirect) of maternal mortality, certain socio-cultural and socioeconomic factors influence the outcome of pregnancy. Also, a poor health care system, which is a consequent of weak social structure, is a contributing factor. CONCLUSION: As a result, maternal mortality has debilitating effects on the socioeconomic development of any nation. It is therefore pertinent for the government to improve maternal health and eradicate poverty to ensure sustainable development.

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