scholarly journals One Year Review of Maternal Mortality Associated With Eclamsia in a Tertiary Care Level Hospital

2013 ◽  
Vol 23 (2) ◽  
pp. 30-33
Author(s):  
Shamima Siddiqual ◽  
Md Mahbub Alam ◽  
Mahbub Ara Khatun
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Economic Status ◽  
Multiorgan Failure ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Traditional Birth Attendant ◽  
Case Fatality ◽  
Level Of Care ◽  
College Hospital

To enlist the causes of maternal death in patients of eclampsia and to determine how sociodemograpphic and clinical characteristics of the women influence the death in eclampsia in our setup. This study was conducted in obstetrics and gynaecology department of Chittagong Medical College Hospital, Chittagong, from January 2011 to December 2011. Patients were admitted through emergency obstetrics care unit. Patients demographic record including age, parity, education, socio-economic status along with antenatal care records, level of care and distance from hospital number of fits, gestational age, type of eclampsia, presence of complications, mode of delivery and causes of death were analyzed. All this information was collected from patients records. Eclampsia accounted for 38 (37.7%) of the 101 total maternal deaths recorded within the 1 year period, with case fatality of 9.9%.All patients were unbooked and majority were primigridia(63%) and less than 20 years(39%). Education and socioeconomic status were poor. Ante partum eclampsia was the cause in 78.9% and 5.2% of the pregnancies were not delivered before their death. Overall 23% patients had at least one complications and the remaining 67% had more than one complications. The complications leading to eventual death were pulmonary oedema 7(18.4%), LVF 6(15.7%), CVD 6(15.7%), Multiorgan failure 6(15.7%), HELLP 4(10.5%), DIC 3(7.8%), Renal failure 3(7.8%), peroperative cardiac arrest 2(5.2%) and pulmonary embolism 1(2.6%). The distance from the hospital was 10km to 150km. The level of care at nearest health facilities were estimated.52.6% was attended by traditional birth attendant, 6.9% by skilled birth attendants, 2.9% by doctors and for 25.7%, no level of care was available. Eclampsia stil remains the major cause of maternal mortality in our setup resulting from unsupervised pregnancies and deliveries. There is need to educate and encourage the general public for antenatal care and hospital delivery. JCMCTA 2012 ; 23 (2): 30-33

scholarly journals An analysis of trends in maternal mortality at a tertiary care teaching hospital of Western Rajasthan, India: a four year retrospective study

2017 ◽  
Vol 4 (3) ◽  
pp. 864
Author(s):  
Neha Agrawal ◽  
Sandeep Kumar Uppadhaya ◽  
Afzal Hakim ◽  
Manish Mittal
Keyword(s):  
Maternal Mortality ◽  
Health Care Services ◽  
Economic Status ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Tertiary Hospital ◽  
College Hospital ◽  
Medical College ◽  
Care Services ◽  
Mortality Ratio

Background: Maternal mortality reflects not only the adequacy of health care services of any country or state but also the standard of living and socio-economic status of the community. India is among those countries, which has a very high maternal mortality ratio; the state of Rajasthan having the third highest maternal mortality in the country. This study was done to assess the maternal mortality in a tertiary hospital situated in Jodhpur, a city in Western Rajasthan where large numbers of patients are referred from rural parts in and around the city.Methods: This study was done to assess the trends in maternal mortality at a tertiary medical college hospital situated in Western Rajasthan. A retrospective hospital based study was carried out in the Obstetrics and Gynaecology Department of Ummaid hospital, Dr S. N. Medical College situated in Jodhpur, Rajasthan, India over a period of 4 years from July 2010 to June 2014.Results: During the study period spanning 4 years, there were in total 84,746 live births with 195 maternal deaths. The mean maternal mortality ratio for the four year period was found to be 230.1 per lakh live births.Conclusions: The maternal mortality was quite high than the national average.

scholarly journals Obstetric Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Care Institute in India

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Niyaz Ashraf ◽  
Sandeep Kumar Mishra ◽  
Pankaj Kundra ◽  
P. Veena ◽  
S. Soundaraghavan ◽  
...  
Keyword(s):  
Intensive Care ◽  
Maternal Mortality ◽  
Multiorgan Failure ◽  
Tertiary Care ◽  
College Hospital ◽  
Medical College ◽  
Obstetric Haemorrhage ◽  
Tertiary Hospitals ◽  
The Mean ◽  
One Year

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.

scholarly journals Study of fetomaternal outcome in eclampsia

2020 ◽  
Vol 9 (10) ◽  
pp. 4155
Author(s):  
Manju Agarwal ◽  
Akanksha Gautam
Keyword(s):  
Antenatal Care ◽  
Perinatal Mortality ◽  
Early Recognition ◽  
Economic Status ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Study Data ◽  
Neonatal Deaths ◽  
Medical College ◽  
Unfavourable Cervix

Background: Eclampsia is a life-threatening emergency that continues to be a major cause of maternal and perinatal mortality. The purpose of our study was to analyse the trend of eclampsia in a tertiary care teaching institute and to find out the fetomaternal outcomes of eclampsia.Methods: A retrospective epidemiological study was undertaken in the department of Obstetrics and Gynaecology, Jhalawar medical college, Jhalawar during the period ‘September 2018 to August 2019’. Women who presented as eclampsia or developed eclampsia during hospital stay were included in the study. Data analysed included various maternal parameters, fetal parameters, and the outcome of the pregnancy.Results: The incidence of antepartum eclampsia was (0.92%). High risk associated factors were primigravida (65.90%), low maternal age (21-30 years), illiteracy, and inadequate antenatal care. Caesarean section was the mode of delivery in 48 cases (54.54%) most common indication was unfavourable cervix, 80.6% women had antepartum eclampsia and 68.18% women had severe preeclampsia. There was 6.8% maternal mortality, attributed to pulmonary edema and acute renal failure. Perinatal mortality was 14.77% with 8 still births and 5 neonatal deaths. Prematurity complicated 46.66% pregnancies. Thirty neonates were admitted to NICU.Conclusions: Eclampsia is one of the important causes of maternal and perinatal morbidity and mortality due to lack of proper antenatal care, low socio-economic status, and lack of education. It can be concluded that better antenatal care, early recognition of disease, timely referral, early initiation of treatment and termination of eclamptic patients improves outcome. Management of eclamptic patients should be performed at tertiary care centres, where ICU facilities, NICU facilities, and multidisciplinary units are available.

scholarly journals Peripartum hysterectomy: a five year review at a tertiary care centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3590
Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria
Keyword(s):  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
College Hospital ◽  
Peripartum Hysterectomy ◽  
Medical College ◽  
Obstetric Haemorrhage ◽  
Suboptimal Care

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. 

A study on perception about antenatal care among primigravida attending a tertiary care hospital

2019 ◽  
Vol 9 (1) ◽  
pp. 56
Author(s):  
Priya Somu ◽  
Sakthi Narmatha D.
Keyword(s):  
Mortality Rate ◽  
Antenatal Care ◽  
Care Center ◽  
Tertiary Care ◽  
Infant Mortality Rate ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Health Care Center ◽  
Basic Care

Background: Maternal mortality rate and Infant mortality rate remains high in India when compared to several other countries. Understanding and being aware about the basic care provided during pregnancy is an important factor to make the pregnant woman to utilize the antenatal care. Hence this study was planned to assess the existing knowledge of primi gravid mothers attending the tertiary health care center about the various antenatal care services provided.Methods: This cross-sectional study was conducted among the primi gravid females attending the outpatient department of Obstetrics and Gynecology in Sri Muthukumaran Medical College Hospital and Research Institute, Chennai during months of June 2018 to May 2019. A total of 280 primi gravid mothers were included in the study. Data was collected through one to one interview and analyzed using statistical package for social sciences (SPSS) version 17.Results: In this study 82.9%, 70.4%, 80.7% of the mothers were aware about consumption of IFA tablets, TT injection and adequate ANC visits, respectively. PNDT act was known to 76.1% of the participants. Only 12.5% of the primi mothers were aware about Janani Suraksha Yojna (JSY) scheme and 91.8% of the mothers were aware about Dr. Muthulakshmi Maternity Benefit scheme.Conclusions: Knowledge about ANC services was found to be fair among the primi mothers but not sufficient, which shows the need for the healthcare professionals to educate young woman even from adolescent age itself.

scholarly journals Maternofoetal Complications and Their Association with Proteinuria in a Tertiary Care Hospital of a Developing Country

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Archana Kumari ◽  
Avinash Chakrawarty ◽  
Abha Singh ◽  
Ritu Singh
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Neurological Involvement ◽  
First Episode ◽  
Care Hospital ◽  
Spot Urine ◽  
High Dependency ◽  
Developed World

Objective. To investigate association between maternofoetal complications and the amount of proteinuria measured by spot urine protein creatinine ratio in patients with preeclampsia.Methods. 200 consecutive patients with preeclampsia were recruited in the study. The complications like first episode of severe hypertension, renal insufficiency, raised level of aspartate transaminase, signs of neurological involvement, thrombocytopenia, eclampsia, and need to shift in intensive care units were studied. The maternal outcome was studied in terms of type of labour, outcome of pregnancy, mode of delivery, indication of cesarean section, and maternal mortality. The foetal complications and outcome parameters were birth weight, Apgar score at the time of birth and at five minutes, need of high dependency unit care, and perinatal mortality.Result. The frequency of various maternal and foetal complications was between 14–53% and 22–92%, respectively. Maternal mortality was 3%, whereas perinatal mortality was 23%. Statistically significant association was found between the frequencies of various complications in mother and newborn and spot UPCR.Conclusion. The rate of various maternofoetal complications in preeclampsia is higher in developing countries than in developed world. Maternofoetal complications and outcome correlate with maternal spot UPCR.

scholarly journals Pattern of Adverse Drug Reactions Due to Cancer Chemotherapy in Tertiary Care Teaching Hospital in Bangladesh

1970 ◽  
Vol 8 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Sneegdha Poddar ◽  
Razia Sultana ◽  
Rebeka Sultana ◽  
Maruf Mohammad Akbor ◽  
Mohammad Abul Kalam Azad ◽  
...  
Keyword(s):  
Adverse Drug Reactions ◽  
Cancer Chemotherapy ◽  
Economic Status ◽  
Alkylating Agents ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Drug Reactions ◽  
College Hospital ◽  
Medical College

The objective of the present study was to evaluate the pattern of adverse drug reactions (ADRs)occurring in cancer patients treated with chemotherapy in tertiary care hospitals in Bangladesh. A prospectivehospital based study over a period of six month was carried out in the Department of oncology, Bangabandhu SheikhMujib Medical University and Dhaka Medical College Hospital. The data were subjected to descriptive analysis. Atotal of 50 patients having ADRs due to cancer chemotherapy were randomly selected. Adverse drug reactions weremostly occurred in the age group between 41-50 years (26%). Considering socio-economic status of cancer patientsmarried persons (82%) have significantly higher risk than unmarried (18%). Prevalence of breast cancer (20%),cervical cancer (14%) and leukemia (16%) were higher and they were treated mostly by adjuvant chemotherapy(46%) and secondly by chemotherapy (38%) alone. In most cases ADRs were developed in patients receivingalkylating agents (40%) and antimetabolites (40%) as anticancer therapy. The five certain ADRs observed in thecurrent study were nausea, stomatitis, alopecia, myelosuppression and increased ESR level in both male and femalepatients. Moreover, hematological system was affected severely by alkylating agents and antimetabolites. Similarstudies covering more patients from different regions are needed to validate our findings.Key words: ADRs; Cancer; Chemotherapy; Tertiary hospital; Bangladesh.DOI: 10.3329/dujps.v8i1.5330Dhaka Univ. J. Pharm. Sci. 8(1): 11-16, 2009 (June)

scholarly journals Study of Maternal and Foetal Outcome in Abruptio Placentae

2021 ◽  
Vol 8 (01) ◽  
pp. 5208-5213
Author(s):  
Vikram Lokhande ◽  
Kunal Jadhav ◽  
Minal Kadam ◽  
Suresh Rawte
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Abruptio Placentae ◽  
Foetal Outcome ◽  
Obstetrical Emergency ◽  
Time Of Admission

Study of Maternal and Foetal outcome in Abruptio Placentae Introduction: Abruptio placentae (AP) is a significant obstetrical emergency and as per WHO 2009 maternal mortality rates reported due to AP worldwide was 2.1% and fetal perinatal mortality rate was 15%. AP cannot be prevented but maternal and perinatal morbidity and mortality due to AP can be reduced significantly by aggressive management.   Methods: The present prospective study was conducted to evaluate the outcome of treatment on the perinatal and maternal outcome in Abruptio Placentae patients in a tertiary care hospital from January 2015 to January 2016 amongst 54 pregnant women diagnosed to have abruptio placentae from 28 weeks of gestation and above and all babies delivered. Face-to-face interviews was conducted. Results: Maximum no. of abruptio placentae were unbooked - 37 (69%) and 85% of patients belonged to the less than 30 years of age group. An abruptio placenta was more common in multipara. Anaemia was seen in 21 patients (38%). Anaemia and PIH was seen in 12 patients (23%). 7 patients had fetal distress at the time of admission (13%). Regarding mode of delivery, 50% of patients delivered vaginally by artificial rupture of membrane (ARM) and oxytocin augmentation and 50% underwent caesarean section. Conclusion:  It was concluded that abruptio placentae is still a leading cause of maternal morbidity and mortality that can be reduced with modern management of abruptio placentae, but timely diagnosis and intervention is necessary. Key Words: Abruptio placentae, maternal mortality, fetal distress, anaemia

scholarly journals Eclampsia at a tertiary care hospital of Nepal: A five year study

2018 ◽  
Vol 6 (2) ◽  
pp. 14-21
Author(s):  
Shraddha Rana ◽  
Pramod Kattel
Keyword(s):  
Blood Pressure ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Mortality ◽  
Care Hospital ◽  
Cross Sectional ◽  
National Medical

Background and Objectives: Eclampsia poses a global threat in terms of feto-maternal morbidity and mortality and all medical practitioners fear the ailment. It is one of the major causes behind preventable maternal death. Etio-pathogenesis of the disease condition is ambiguous and is considered to be multi-factorial. This study was done to analyze cases of eclampsia in relation to maternal and fetal outcomes at a tertiary level care hospital. Materials and Methods: A descriptive cross-sectional observational study was carried out in patients developing eclampsia over a period of five years starting from July 2011 to June 2016 at National Medical College and Teaching Hospital, Birgunj. Relevant data were collected from the statistics section of hospital reviewing the case sheets. Results: There were 291 cases of eclampsia out of 16,445 deliveries and prevalence of eclampsia was calculated to be 1.77%. Fourty-five percent of eclamptic women had age less than 20 years and two-third was primigravida. Approximately 84% of women were unbooked. Antepartum eclampsia was observed in 78.8% followed by postpartum eclampsia (14.8%) and intrapartum eclampsia (6.5%).  At the time of admission systolic blood pressure more than 140 mmHg and diastolic blood pressure more than 90 mmHg were noted in 79% and 92.1% cases respectively. Caesarean section was the preferred mode of delivery and was performed in 62.9% cases. ICU admission was required in 35.7% and remaining cases were managed in general/eclampsia ward. Renal failure was the most common cause of maternal mortality seen in 29.4%. Still birth was noted in 13.4%. Conclusion: Institutional obstetric patients are gradually facing eclampsia as prime cause of maternal death and unfortunately most of the cases are primigravid at younger age. All health care professionals should be proficient to manage eclamptic women instantaneously. Key words: Eclampsia; Fetal Mortality; Maternal Mortality; Pre-Eclampsia

scholarly journals Study of maternal and fetal outcome in antepartum eclampsia in a tertiary care hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 1108
Author(s):  
Aruna Rani R. ◽  
Dheeba Jayanthi R. ◽  
Eswari S.
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Obstetric Emergencies ◽  
One Year ◽  
A Prospective Study

Background: In modern obstetrics, the prevalence of Eclampsia and its complications are high, so we decided to study pregnancy outcome in all Antepartum Eclampsia patients. The present study was carried out to investigate the maternal and fetal outcome in patient with Antepartum eclampsia.Methods: A prospective study was conducted in Government Mohan Kumaramangalam Medical College Hospital, Salem, India over a period of one year from January 2016 to December 2016 in all Antepartum Eclampsia patients. Analysis was done regarding the age of women, parity, gestational age, imminent symptoms, mode of delivery, fetal outcome and maternal morbidity and mortality.Results: Incidence of Antepartum Eclampsia in our hospital is 0.7%. It is more common in age group of 20 to 25years (68.5%) and primigravida (56%) and gestational age >37 weeks (51.85%). Commonest mode of delivery was by caesarean section (72%). Out of 54 patients of Antepartum Eclampsia 3 (5.5%) died and 18 (33%) had complications. Out of 50 live babies, 16 (32%) died.Conclusions: Eclampsia is still one of the important and common obstetric emergencies and it has a significant role in maternal and fetal outcome. The early identification of risk factors and timely intervention is needed to improve maternal and perinatal outcome.

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