scholarly journals Obstetric Haemorrhage Related Maternal Mortality: A Two-Year Experience at a Teaching Hospital in Bangladesh

2021 ◽  
Vol 8 (2) ◽  
pp. 90-94
Author(s):  
Tahmina Ahmed ◽  
Nazmul Haque ◽  
Bithi Debnath ◽  
Samsunnahar Begum

Background: Bangladesh is one of the developing countries where the maternal mortality is extraordinarily high. Objectives: This study was conducted to find out the number and cause of obstetric haemorrhage related maternal death. Methodology: This retrospective study was conducted in the department of obstetrics & gynaecology at M.A.G Osmani Medical College Hospital, Sylhet, Bangladesh from January 2006 to December 2007. From all maternal deaths related to pregnancy occurred in that period, only death due to obstetric hemorrhage were enrolled. Thereafter, the records of hemorrhage related death patients were scrutinized and data were collected from death register. All necessary information was collected in a pre-designed clinical data sheet and analyzed. Results: Among all deaths in obstetric unit, maternal mortality due to obstetric haemorrhage was 32.09%. The deaths were common among multipara (3-4) in 26-30 years age group. Most of them were from lower socio-economic condition having no or irregular antenatal checkup. Among the causes of obstetric haemorrhage, PPH was the commonest. Atonic uterus was the main cause of PPH. Injudicious use of oxytocin and obstructed labour were the common cause of rupture of uterus. Although the causes of haemorrhage were different, most of the patients died due to haemorrhagic shock. Conclusion: This study helps to detect the magnitude of problem and major causes of maternal deaths specially haemorrhage related maternal deaths. Journal of Current and Advance Medical Research, July 2021;8(2):90-94

Mediscope ◽  
2018 ◽  
Vol 5 (1) ◽  
pp. 28-32
Author(s):  
SA Tazri ◽  
M Ahmed ◽  
MN Shumsun ◽  
AM Raza

The aim of the study was to find out the risk factors and causes of maternal mortality in rural hospitals of Bangladesh. The retrospective study was conducted at the Department of Obstetrics and Gynaecology, Jahurul Islam Medical College Hospital with duration of 3 years from May 2009 to April 2012. Total number of maternal deaths was 21 yielding the rate of maternal death as 7.0 per 1000 live births during the study period. The risk factors were age ranging from 21 to 25 years, primigravida, low socioeconomic condition, and less antenatal checkup. Eclampsia was the leading cause of death followed by obstetric hemorrhage, unsafe abortion, obstructed labour.Mediscope Vol. 5, No. 1: Jan 2018, Page 28-32


2010 ◽  
Vol 17 (02) ◽  
pp. 291-294
Author(s):  
AISHA ABDULLAH SHAIKH ◽  
SADIA SABOOHI ◽  
RUBINA A D MEMON

Objectives: To analyse the maternal mortality with its causes and possible contributing risk factors at Ghulam Mohammad Mahar Medical College Hospital, Sukkur. Setting: This study was carried out at Gynae / Obs Unit-1 of Ghulam Mohammad Mahar Medical College Hospital, Sukkur from Jan-2007 to Dec-2008. Study Design: Descriptive case series study. Subjects and Methods: This study was conducted by analysing the death records of all maternal deaths who died over a period of two (02) years from Jan 2007 to Dec 2008. Thedemographic record included age, parity, booking status and education. The cause of death and possible contributing factors were evaluated. Results: 48 mothers died during this period making Maternal Mortality Ratio (MMR) of 1578/ 100,000 live births. Direct causes contributed to 79% (38) of maternal deaths while 21% (10) were due to indirect causes. The major causes of deaths were eclampsia 27% (13), haemorrhage33% (11), Sepsis 21% (10), Obstructed labour 8% (4). Among indirect causes, hepatic encethalopathy, anemia and renal failure were observed. Conclusions: Eclampsia, haemorrhage and Sepsis are still the major killers. Factors which need urgent improvement include education, antenatal booking, early diagnosis and referrals to tertiary care centers.


Author(s):  
Shobha G. ◽  
Jayashree V. Kanavi ◽  
Veena B. Divater ◽  
Annamma Thomas

Background: The objectives of this study were to calculate the maternal mortality ratio, causes for maternal death in our institution and the duration of hospital admission to death interval.Methods: The study included collecting and analyzing the details of maternal death in women who were admitted to St. Johns Medical College Hospital, Bengaluru, from January 2007 to December 2016. Results: Total maternal deaths were 61 and live births were 26,001 during the study period. The maternal mortality ratio (MMR) was 234.6 per 100,000 live births. Majority of maternal deaths occurred in women aged 18 - 35 years 56 (91.80%) women, primipara 45 (73.77%) and referred cases to our institution from other hospitals 52 (85.24%).                      Most of the women died in the postnatal period 54 (88.52%). Direct obstetric causes accounted for 44 (72.13%) maternal deaths and indirect causes 17 (27.86%) deaths. Preeclampsia and eclampsia were the leading causes for death 13 (21.31%) followed by acute fatty liver of pregnancy 12 (19.67%), hemorrhage 7 (13.11%) and sepsis 6 (9.83%). Anemia was present in 77.04% of women at the time of admission to our hospital. Thirty six (59.01%) women died within a week of admission to the hospital, in which 13 (21.31%) women died in less than 24hours of admission. Twenty five (40.98%) women died after a week of admission to hospital.Conclusions: Apart from the triad of preeclampsia, obstetric haemorrhage and sepsis, acute fatty liver of pregnancy has emerged as an important cause of maternal death. Most of the maternal deaths are preventable. Early detection of complications and timely referral to tertiary care hospital in St. Johns Medical College Hospital, Bengaluru, Karnataka, India decreases maternal morbidity and mortality.


2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Niyaz Ashraf ◽  
Sandeep Kumar Mishra ◽  
Pankaj Kundra ◽  
P. Veena ◽  
S. Soundaraghavan ◽  
...  

Background and Objectives.Critically ill obstetric patients are a particularly unique cohort for the intensivist. The objective of this study was to review the indications for admission, demographics, clinical characteristics, and outcomes of obstetric patients admitted to intensive care unit of a medical college hospital in southern India and to identify conditions associated with maternal mortality.Design.Retrospective analysis of pregnant/postpartum (up to 6 weeks) admissions over a 1-year result. We studied 55 patients constituting 11.6% of mixed ICU admissions during the study period.Results.The mean APACHE (acute physiology and chronic health evaluation) II score of patients at admission was 11.8. Most of the patients (76%) were admitted in the antepartum period. The commonest indications for ICU admission were obstetric haemorrhage (51%) and hypertensive disorders of pregnancy (18%). 85% of patients required mechanical ventilation and 78% required inotropic support.Conclusions.Maternal mortality was 13%, and the majority of the deaths were due to disseminated intravascular coagulation and multiorgan failure, following an obstetric haemorrhage. A dedicated obstetric ICU in tertiary hospitals can ensure that there is no delay in patient management and intensive care can be instituted at the earliest.


Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 


2020 ◽  
Vol 19 (6) ◽  
pp. 117-123
Author(s):  
T.E. Belokrinitskaya ◽  
◽  
N.V. Artymuk ◽  
O.S. Filippov ◽  
E.M. Shifman ◽  
...  

Objective. To perform comparative analysis of parameters and structure of maternal mortality (MM) in the Far Eastern Federal District (FEFD) and Siberian Federal District (SFD) in 2014–2019. Materials and methods. The database for analysis was generated using map-based emergency notifications of maternal deaths (69 in FEFD and 180 in SFD). We used methods of descriptive statistics, Pearson's χ2-test, and calculated odds ratios (ORs) with 95% confidence intervals (95% CIs). Results. Between 2014 and 2018, the dynamics of MM in the FEFD and SFD had a one-way trend: it decreased in 2014–2017, but dramatically increased in 2018 primarily due to social factors. In 2019, we observed a significant growth of MM in the FEFD, while the SFD demonstrated a reduction of MM. The most common cause of maternal death in both districts was extragenital diseases. However, there were some differences in the structure of obstetric causes: in FEFD, preeclampsia and obstetric hemorrhage were the most frequent obstetric causes of death, while in SFD, women primarily developed embolism and placental abruption. Conclusion. The dynamics and structure of MM in the FEFD and SFD require management decisions aimed at improving medical care with the consideration of clinical guidelines, organization of continuous audit, systematic development of practical teamwork skills both in simulation training centers and healthcare institutions. Key words: Far Eastern Federal District, maternal mortality, Siberian Federal District


Author(s):  
Jayasree Hansda ◽  
Debobroto Roy ◽  
Krishnapada Das ◽  
Manojit Sarkar ◽  
Rumpa Das ◽  
...  

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.


Author(s):  
Sona Singh ◽  
Nagendra Singh ◽  
Jagriti Kiran Nagar ◽  
Sarvesh Jain

Background: Maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of pregnancy from any cause related to or aggravated by the pregnancy, but not from accidental or incidental causes. The aim of this study is to find out the causes of maternal mortality and the complications leading to maternal death.Methods: A retrospective study was conducted by reviewing the hospital records to study the maternal deaths and complication leading to maternal death over the period of one year from July 2016 June 2017 in the Department of Obstetrics and Gynecology, Bundelkhand Medical College, and associated hospital Sagar, Madhya Pradesh. All the maternal deaths were scrutinized for various aspects likely to be related to death such as age, locality of residence, antenatal care, admission death interval and the cause of death.Results: The maternal mortality ratio in the present study is 292.33/100,000 live births. There were 28 maternal deaths out of 9578 live birth during the study period. The majority of deaths occurred in the 20-30 age group. hemorrhage (32.14%) and hypertensive disorders (14.28%) are two most common direct cause of maternal deaths. 42.85% of maternal deaths occurred within the first twenty-four hours of admission. Post-operative and post abortal sepsis, amniotic fluid embolism and pulmonary embolism are other direct causes. Indirect causes of maternal deaths account for 21.42%. Severe anemia was the leading indirect causes of maternal deaths.Conclusions: Hemorrhage, hypertensive disorders, and anaemia remain the major cause of maternal deaths. Delay in decision making, provision of treatment and referral to tertiary centre contributed higher maternal mortality. This requires more efforts to recognize the direct and indirect causes of maternal deaths.


1970 ◽  
Vol 8 (2) ◽  
pp. 64-68
Author(s):  
Md Zahirul Haque ◽  
Saki Md Jakiul Alam ◽  
Mesbahuddin Noman ◽  
MA Azhar

This study was done in medicine indoor department of Rajshahi Medical College Hospital from January 2004 to March 2004. Consecutive 100 patients, who were advised to test the ESR by their physicians for their complaints and found to have an ESR, equal to or more than 100 mm in 1st hour, were included in this study. Among 100 patients 56 were male and 44 were female. All of them were classified in five age groups. They were also categorized according to their monthly income and occupation. Fever, generalized weakness, weight loss, pallor, pain, body ache were the common presenting complaints. Haematological disorder appeared to be most common cause (41%) of marked ESR elevation; followed by infectious diseases (36%) and connective tissue disorders (17%). Among the all patients 30% cases were haematological malignancies (i.e. acute myeloblastic and lymphoblastic leukaemia, lymphomas, multiple myeloma). In 4% cases the cause could not be elicited.    DOI = 10.3329/jom.v8i2.1411 J MEDICINE 2007; 8 : 64-68


1970 ◽  
Vol 8 (2) ◽  
pp. 222-226 ◽  
Author(s):  
NS Shrestha ◽  
R Saha ◽  
C Karki

Background: Maternal mortality traditionally has been the indicator of maternal health all over the world. More recently review of the cases with near miss obstetric events has been found to be useful to investigate maternal mortality. Cases of near- miss are those in which women present with potentially fatal complication during pregnancy, delivery or the puerperium, and survives merely by chance or by good hospital care. Objectives: The objective of this study is to determine the prevalence and nature of near miss obstetric cases and maternal deaths at Kathmandu Medical College Teaching Hospital. Material and methods: This was a descriptive study done for the period of 24 months (1 January 2008 to 31 December 2009). Cases of severe obstetric morbidity were identified during daily morning meetings. All the cases were followed during their hospital stay till their discharge or death. Five factor scoring system was used to identify the near miss cases from all the severe obstetric morbidity. For each case of maternal death, data were collected from records of maternal death audit. Results: During the study period, 1562 women delivered at the institution and 36 women were identified as near-miss obstetrical cases. The prevalence of near miss case in this study was 2.3%. Five maternal deaths occurred during this period, resulting in a ratio of maternal death of 324 maternal deaths per 100,000 live births. Of the five maternal deaths three were due to pregnancy complicated with hepatitis E infection, one each due to Eclampsia and amniotic fluid embolism. Fifteen cases of near miss were due to haemorrhage (41.66%) and hypertensive disorder of the pregnancy was the cause in 10 (27.77%). Dystocia was the cause in 1(2.77%) case and infections in 7(19.4%) cases. Rare causes like anaesthetic complications were the cause in one case and dilated cardiomyopathy was the cause in two cases. Conclusion: The major causes of near-miss cases were similar to the causes of maternal mortality of Nepal. Need for the development of an effective audit system for maternal care which includes both near-miss obstetric morbidity and mortality is felt. Key words: Near-miss obstetric morbidity; Maternal mortality; Five factor scoring system DOI: 10.3126/kumj.v8i2.3563 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 222-226


Sign in / Sign up

Export Citation Format

Share Document