scholarly journals Audit of Maternal Deaths in the Context of the Free Obstetrical Care at the Maternity of the Ignace Deen National Hospital of Conakry Chu

2021 ◽  
Vol 6 (1) ◽  
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Low Income ◽  
Obstetric Care ◽  
Blood Products ◽  
National Hospital ◽  
Maternal Deaths ◽  
Major Health Problem ◽  
Live Births ◽  
Technical Platform

Objectives: To describe the evolution of half-yearly maternal mortality ratios, to describe the socio-demographic characteristics of the patients who died in the facility, to analyse the causes and determining factors of maternal deaths that have occurred in the facility, and to implement strategies to reduce this maternal mortality. Methodology: this was a descriptive, cross-sectional and analytical study carried out at the maternity ward of the Ignace Deen National Hospital of the Conakry University Hospital with data collection in two phases, including a retrospective lasting 6 months from July 1 to December 31, 2018, and the other prospective for a period of 18 months from January 1, 2019, to June 30, 2020. Result: During the study period, 224 deaths were recorded out of a total of 8,539 live births, for an intra-hospital maternal mortality ratio of 2,623.25 per 100,000 live births. The profile of women at risk of maternal death was as follows: patients aged 20-31 (56.26%), married (87.6%), low-income (41.96%), multiparous (33, 1%), evacuated from a peripheral maternity hospital (79.91%), multi guest (34.9%). The majority of deaths occurred within the first 24 hours (75%). The majority of deaths were due to direct obstetric causes: postpartum haemorrhage (52.68%), eclampsia (21.88%). Indirect obstetric causes were dominated by anaemia (16.07%). But in some cases, two or even three factors were associated with the occurrence of the same maternal death. The most frequently encountered obstetric period of death was postpartum (77.68%). The average recovery time was 31.96 minutes. The lack of blood products and the inadequacy of the technical platform were the main associated factors. Also, it appears that all our cases of death were preventable. The causes of the dysfunctions were attributable: to the person by their attitude (delay in specific care); in the hospital for the lack of equipment and blood products and in the consultation. Free obstetric care was not complete in some cases. Conclusion: maternal mortality is a major health problem in our structure. Its reduction requires the mobilization of all actors in society involving good health education; improving the quality of prenatal consultations and emergency obstetric care by consciously taking charge of staff and strengthening the technical platform.

scholarly journals MATERNAL MORTALITY

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.

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

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.

Factors Cause of Maternal Death in Timor-Leste

2017 ◽  
Vol 3 (2) ◽  
pp. 30
Author(s):  
Feliciano Pinto ◽  
I Ketut Suwiyoga ◽  
I Gde Raka Widiana ◽  
I Wayan Putu Sutirta Yasa
Keyword(s):  
Health Status ◽  
Maternal Health ◽  
Health Behaviors ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Good Health ◽  
Birth Spacing ◽  
Maternal Deaths ◽  
Live Births ◽  
Timor Leste

Maternal mortality was an indicator of basic health services for mothers or women of reproductive age of a country and was one of the eight Millennium Development Goals (MDGs). Factors that affect maternal mortality, among others: medical factors, non-medical factors, and health care system factors. Meanwhile, WHO (2010) reported that the cause of maternal mortality in the world is 25% of bleeding, 15% of infection/sepsis, 12% eclampsia, 13% of abortions are unsafe, 8% obstructed and ectopic pregnancy, 8% embolisms and other related issues with anesthetic problems. WHO (2010) has determined that the maternal mortality rate (MMR) in 40 countries ≥ 300 / 100,000 live births including República Democrática de Timor-Leste at 557 / 100,000 live births. Objective: This study aimed to determine the relationship between the variables of age, parity, spacing pregnancies, health behavior, and health status of mothers with maternal deaths. Methods: The study design was a cross-sectional study with a sample of 298 pregnant women in 13 districts throughout Timor-Leste. Results: Maternal deaths are caused by independent variables simultaneously and the remaining 28.0% were prescribed other factors. Low maternal health behaviors that lead to maternal death by 40.348 times higher compared with mothers who have good health behaviors. The health status of low maternal causes of maternal mortality by 23.340 times higher than mothers who have a good health status. Birth spacing ˂ two years caused the death of the mother of 16.715 times higher than women with birth spacing ˃ 2 years. Maternal age and parity variables showed no significant effect. Conclusion: There was a significant relationship between behavioral maternal health, maternal health, birth spacing with maternal mortality while age and parity are not related.

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 Estimating Maternal Mortality Level in Rural Northern Nigeria by the Sisterhood Method

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Henry V. Doctor ◽  
Sally E. Findley ◽  
Godwin Y. Afenyadu
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Lifetime Risk ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Northern Nigeria ◽  
Maternal Deaths ◽  
Live Births ◽  
Sisterhood Method

Maternal mortality is one of the major challenges to health systems in sub Saharan Africa. This paper estimates the lifetime risk of maternal death and maternal mortality ratio (MMR) in four states of Northern Nigeria. Data from a household survey conducted in 2011 were utilized by applying the “sisterhood method” for estimating maternal mortality. Female respondents (15–49 years) were interviewed thereby creating a retrospective cohort of their sisters who reached the reproductive age of 15 years. A total of 3,080 respondents reported 7,731 maternal sisters of which 593 were reported dead and 298 of those dead were maternal-related deaths. This corresponded to a lifetime risk of maternal death of 9% (referring to a period about 10.5 years prior to the survey) and an MMR of 1,271 maternal deaths per 100,000 live births; 95% CI was 1,152–1,445 maternal deaths per 100,000 live births. The study calls for improvement of the health system focusing on strategies that will accelerate reduction in MMR such as availability of skilled birth attendants, access to emergency obstetrics care, promotion of facility delivery, availability of antenatal care, and family planning. An accelerated reduction in MMR in the region will contribute towards the attainment of the Millennium Development Goal of maternal mortality reduction in Nigeria.

scholarly journals Review Article on Emergency Obstetric Care

2018 ◽  
Vol 1 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Silas Ochejele
Keyword(s):  
Maternal Mortality ◽  
Low Income ◽  
Newborn Care ◽  
Emergency Obstetric Care ◽  
Skilled Birth Attendant ◽  
Obstetric Care ◽  
Functional Health ◽  
Low Income Countries ◽  
Mortality Reduction ◽  
Maternal Deaths

Maternal death was once a common occurrence worldwide but today, 99% of maternal deaths occur in low income countries. Most of the maternal deaths are due to direct obstetric complications. Emergency obstetric care is the intervention required to save the lives of these women. It is based on a tripod of signal functions, skilled birth attendants and a functional health system. The objective of this article was to discuss the role of Emergency obstetric care in maternal mortality reduction. A systematic review of available articles on Emergency obstetric care; and Emergency obstetric care training materials, experience and observations used/made between 2003 and 2017 in Nigeria was used for this work. Emergency obstetric care is the nucleus on which all other maternal mortality reduction activities are hinged. The paradigm evolvement of Emergency obstetric care offers the last hope for a woman with direct obstetric complication. However, the skilled birth attendant must have the right attitude in addition to her/his professional skills for effective implementation of these interventions. Women need access to and availability of Emergency obstetric care as well as a continuum of care that includes antenatal, intra-partum and postnatal care, newborn care and family planning services to reduce maternal mortality.

scholarly journals Maternal mortality at a tertiary care teaching hospital in Dibrugarh district, Assam: a retrospective study

2017 ◽  
Vol 4 (9) ◽  
pp. 3342
Author(s):  
Lima Hazarika ◽  
Pranay Phukan ◽  
Anand Sharma ◽  
Nabajit Kr. Das
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Teaching Hospital ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Deaths ◽  
Tertiary Care Teaching Hospital ◽  
Live Births ◽  
Care Teaching

Background: Maternal mortality is a measure of quality of health care in a community. Assam has the highest maternal mortality rate among all India’s states, which is almost double the national average, with around 328 deaths per 100 000 live births. Three quarters of these deaths are among the tea plantations community. It has serious implications on the family, the society and the nation. Maternal mortality rate (MMR) is a very sensitive index that reflects the quality of reproductive care provided to the pregnant women. The objective of the study was to assess the Institutional maternal mortality and the causes of maternal death over a period of a year at a Tertiary Care Teaching Hospital in Dibrugarh district, Assam.Methods: A retrospective hospital based study of maternal death cases from September 2015 to August 2016 was conducted to assess the maternal mortality. The study was carried out in the Obstetrics and Gynaecology Department of Assam Medical College and Hospital (AMCH), Assam. The study included 48 maternal deaths in the year. The information regarding reproductive parameters was collected from the maternal death register and the results were analyzed by using percentage.Results: Out of 9789 total deliveries, Institutional Maternal Mortality was found to be 490 per 1, 00,000 live births. The maternal death was high among the Tea Garden community (66.7%) at the age group 15–20 years and was prevalent mainly in the illiterates (31.3%). Anaemia (29.1%) was the leading cause of death; followed eclampsia (23.0%) and septicaemia (17.0%) while cardio respiratory failure was indirect leading cause for maternal deaths.Conclusions: There is a wide scope for improvement as a large proportion of the observed deaths were preventable. Most maternal deaths can be limited by utilisation of existing medical facilities and identifying the barriers in accessing health delivery system. Early identification of high risk pregnancies and regular ante-natal check up with timely referral to tertiary care centre can help reduce the mortality among the women. 

scholarly journals Study of causes and facility based lags in a tertiary care hospital contributing to maternal mortality

2017 ◽  
Vol 6 (5) ◽  
pp. 2044
Author(s):  
Ajit Kumar Nayak ◽  
S. Dhivya ◽  
Tajma Afzal
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Kidney Diseases ◽  
Tertiary Care ◽  
Cost Effective ◽  
Time Frame ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Live Births ◽  
Level I

Background: Maternal death is a tragic situation as these deaths occur during or after a natural process like pregnancy. By addressing the three levels of delays i.e., delay in seeking care, delay in reaching care and delay in receiving care; it can be prevented to a fair extent.Methods: All maternal deaths occurred in SCB Medical College and Hospital, Cuttack between September 2015 to September 2016 included in the study, Antepartum and postpartum events were documented as per the proforma. Opinions of respective faculties regarding diagnosis, treatment, possible preventable factors and any delays and lapses at our set up were obtained.Results: There were 10060 live births and 121 maternal deaths, giving the hospital based incidence of maternal mortality as 12.02 per 1000 live births. 42.98%, 6.61% and 50.41% of death were due to Level I, Level II and level III delays respectively. The delays due to unavailability of appropriate facilities in our institution are highlighted. Lack of ICU facility accounted 37.19% deaths. Unavailability of blood, a delay in surgery, delayed multispecialty referral and required investigation follow it. 91.7%. deaths were preventable.Conclusions: Hypertension, Obstetric hemorrhage, liver and kidney diseases were mainly responsible for maternal mortality. Facility based maternal death review system help in finding out the constraints in the existing system. It brings a sense of responsibility in all stake holders involved in delivery of MCH care. It is feasible and cost effective strategy to reach Millennium Development target 5 in extended time frame.

Maternal Death Audit: Experience from a Periurban Hospital

1970 ◽  
Vol 24 (1) ◽  
pp. 5-9
Author(s):  
S Tasnim ◽  
N Kabir ◽  
A Rahman ◽  
A Ahmed ◽  
S Chowdhury
Keyword(s):  
Developing Countries ◽  
Professional Practice ◽  
Maternal Death ◽  
Post Partum ◽  
Obstetric Care ◽  
Maternal Deaths ◽  
Live Births ◽  
Factors Associated ◽  
Cause Of Deaths ◽  
Maternal Death Audit

Maternal death audit is becoming a routine process in the practice of obstetric care in both developed and developing countries. Review of case records of maternal deaths between September 1999 and December 2004 was done to find out the profile of the patients and factors associated with the deaths in a periurban hospital in Dhaka. A total 40 maternal deaths occured among 14,137 live births amounting MMR 282 per 100,000 live births. Mean age of deceased mothers was 24.85± 5.6 years, 25% were primipara and vaginal delivery occurred in 42.46% cases. Thirty percent deaths occured within six hours of admission to hospital and 73% deaths occurred during post-partum period. The primary obstetric cause of deaths were severe pre-eclampsia and eclampsia (42.5%), haemorrhage (17.5%), obstructed labour (12.5%) and sepsis (7.5%) respectively. Facility based audit into maternal deaths provide an opportunity to understand the inciting factors and is recommended to be implemented for improvement of professional practice and management. (J Bangladesh Coll Phys Surg 2006; 24: 5-9)

scholarly journals What can a mother die of at the Parakou University Hospital Center in Africa?

2018 ◽  
Vol 7 (5) ◽  
pp. 1677
Author(s):  
Sosthene Adisso ◽  
Gisele-Estelle T. Agbossaga ◽  
Mukanire Ntakwinja
Keyword(s):  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
University Hospital ◽  
Dominant Factor ◽  
Blood Products ◽  
Cross Sectional ◽  
Maternal Deaths ◽  
Live Births ◽  
The Face ◽  
Hospital Center

Background: Maternal mortality is a scourge that severely undermines Benin and affects its development. The fact is that despite the efforts that have been made for decades, the causes remain unchanged. What is the evolution of maternal deaths in the maternity CHUD of the Borgou-Alibori which serves the departments of the Borgou and the Alibori populated by 1,245,264 inhabitants? The objectives of the present study aim to assess the ratio of maternal deaths, profile of deceased women, causes of death.Methods: This study took place at the maternity CHUD-B and covered a five-year period from January 1, 2010 to December 31, 2014. This is a retrospective, cross-sectional, analytical and descriptive study covering 113 cases of maternal death.  Results: During this period, we noted from 2010 to 2014 an evolution from 953 to 1388 deaths for 100,000 live births. The deceased women were for the most part illiterate, without any profession and married. The main direct causes of maternal deaths in order of frequency are hemorrhage 47.7%, eclampsia 19.5%, infection 9.8%, dystocia 3.5%. Indirect causes account for 19.5% of maternal deaths. The administration of emergency obstetric care has occurred under conditions where the third delay is found in 22.1% of cases with as the dominant factor the non-availability of blood products.  Conclusions: In the face of these circumstances, it is necessary to revise the system of the management of the Gravido-puerperium in the peripheral formations and in the maternity of the CHUD-B and then the conditions of transfer in order to positively influence the reduction of the mortality Maternal. 

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