scholarly journals Maternal Mortality from Induced Abortion in Malawi: What Does the Latest Evidence Suggest?

2021 ◽  
Vol 18 (19) ◽  
pp. 10506
Author(s):  
Calum Miller
Keyword(s):  
Maternal Mortality ◽  
Spontaneous Abortion ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Induced Abortion ◽  
Substantial Proportion ◽  
Unsafe Abortion ◽  
Maternal Deaths

It is commonly claimed that thousands of women die every year from unsafe abortion in Malawi. This commentary critically assesses those claims, demonstrating that these estimates are not supported by the evidence. On the contrary, the latest evidence—itself from 15 to 20 years ago—suggests that 6–7% of maternal deaths in Malawi are attributable to induced and spontaneous abortion combined, totalling approximately 70–150 deaths per year. I then offer some evidence suggesting that a substantial proportion of these are attributable to spontaneous abortion. To reduce maternal mortality by large margins, emergency obstetric care should be prioritised, which will also save women from complications of induced and spontaneous abortion.

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 Maternal mortality and its relationship to emergency obstetric care (EmOC) in a tertiary care hospital in South India

2015 ◽  
Vol 8 (2) ◽  
pp. 86-91 ◽  
Author(s):  
Papa Dasari
Keyword(s):  
Maternal Mortality ◽  
Cause Of Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Emergency Admissions ◽  
Mortality Ratio

Objective: To determine the trends in maternal mortality ratio over 5 years at JIPMER Hospital and to find out the proportion of maternal deaths in relation to emergency admissions. Methods: A retrospective analysis of maternal deaths from 2008 to 2012 with respect to type of admission, referral and ICU care and cause of death according to WHO classification of maternal deaths. Results: Of the 104 maternal deaths 90% were emergency admissions and 59% of them were referrals. Thirty two percent of them died within 24 hours of admission. Forty four percent could be admitted to ICU and few patients could not get ICU bed. The trend in cause of death was increasing proportion of indirect causes from 2008 to 2012. Conclusion: The trend in MMR was increasing proportion of indirect deaths. Ninety percent of maternal deaths were emergency admissions with complications requiring ICU care. Hence comprehensive EmOC facilities should incorporate Obstetric ICU care.

scholarly journals Retrospective analysis of maternal mortality: a paradigm shift from 2010 to 2020

2021 ◽  
Vol 10 (8) ◽  
pp. 3079
Author(s):  
Sujani Kempaiah ◽  
Urvashi . ◽  
Mamatha . ◽  
Jessica Celina Fernandes ◽  
Gayatri Devi Sivasambu ◽  
...  
Keyword(s):  
Health Services ◽  
Maternal Mortality ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Well Being ◽  
Hospital Data ◽  
College Hospital ◽  
Maternal Deaths ◽  
Diagnosis And Management ◽  
Hypertensive Disorders

Background: Maternal mortality is attributed usually to complications that generally occur during or around labour and these are mostly preventable through proper understanding, diagnosis and management of labour complications. The quality of health services women receive during pregnancy, intranatal and postnatal periods are crucial for the survival and well-being of the mother and her newborn baby. The objective was to analyse the changing trends in maternal mortality occurring over a decade, to assess factors associated with maternal mortality and propose effective interventions in preventing such mortality.Methods: It was a retrospective study to analyse maternal mortality between January 2010 and January 2020 in Ramaiah medical college hospital. Data was collected the institutional medical and delivery records and patient details regarding obstetric history, pre-existing comorbidities, cause of death, interventions done was noted and review of maternal mortality was done.Results: The maternal mortality in the present study was 432.73/1 lakh live births. There were 57 maternal deaths in the study period. Most deaths occurred in the 20-25 age group. 42.10% of deaths occurred ninety six hours after admission. Sepsis (42.1%), hypertensive disorders (12.30%) and haemorrhage (10.5%) are the most common direct causes of maternal death. Post-operative and post abortal sepsis, ARDS, cardiogenic shock, pulmonary embolism and AFLP are the other direct causes. Hypertensive disorders (9.64%) and haemorrhage (19.5) is the two leading indirect causes of maternal deaths.Conclusions: Maternal health services should move beyond the focus on emergency obstetric care, to a broader approach that encompasses preventive and early interventions and integration with existing services. Most of the maternal deaths can be prevented if the high risk antenatal women are identified earlier and referred to the tertiary centre earlier for diagnosis and management. 

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 A five-year retrospective study of maternal mortality in a tertiary referral centre

2021 ◽  
Vol 10 (5) ◽  
pp. 1935
Author(s):  
Meenal S. Sarmalkar ◽  
Arun H. Nayak ◽  
Shameel Faisal ◽  
Abhakumari .
Keyword(s):  
Retrospective Study ◽  
Maternal Mortality ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Postnatal Period ◽  
Tertiary Referral Centre ◽  
Maternal Deaths ◽  
Mortality Ratio

Background: The objectives of this study were to calculate the maternal mortality ratio (MMR) and the causes of maternal deaths in an urban tertiary care institution.Methods: A retrospective study of 305 maternal deaths over the period from January 2014 to December 2018 was carried out. Data was analysed using frequency and percentage with the help of Microsoft Excel 2019.Results: The MMR during the study period was 666.75per 100,000 live births. Majority of maternal deaths (130, 42.62%) occurred in age group 21-25 years. Maximum number of women (288, 94.1%) came from urban area. Majority of maternal deaths occurred in referred cases (238, 78.03%) to our institution. Majority were registered cases (235, 77.0%).  Maximum women (201, 62%) died in the postnatal period. Majority of maternal deaths (222, 72.79%) occurred within 7 days of admission. Direct and indirect causes contributed to 40% and 59.67% of maternal deaths. Among the direct causes of maternal deaths, haemorrhage (45, 14.75%)) was the leading causes for death followed by hypertensive disorders (42, 13.77%) and sepsis (11, 9.02%). Tuberculosis (34, 18.68%) was the most common indirect cause of maternal mortality in our study followed by hepatitis (30, 16.48%) and respiratory conditions (25, 9.02%).Conclusions: Adequate surveillance of tuberculosis in the antenatal period, health education of pregnant women, proper antenatal, intranatal and emergency obstetric care in the first referral unit with proper blood banking facilities and timely referral to the tertiary care institute will help to lower the high death rate.

scholarly journals Universal Maternal Rights: A Matter of Life and Death

2021 ◽  
Author(s):  
Alicia Ryan
Keyword(s):  
Developing Countries ◽  
Maternal Mortality ◽  
Obstetric Care ◽  
Maternal Deaths ◽  
Scientific Methods ◽  
Life And Death ◽  
The World ◽  
Positive Effect ◽  
Multiple Obstacles ◽  
Maternal Rights

Childbirth has been a part of our lives since the beginning of time. Without the process none of us would be alive today. So why is it that maternal mortality remains one of the greatest inequities in the world? To date, approximately 500, 000 women die annually due to the lack of appropriate prenatal and obstetric care. Difficulties arising with childbirth cannot be predicted. However, the way in which we react to a situation can have a lasting, positive effect on the countries and the women who are at risk. The ways in which to help reduce the large number of maternal deaths in developing countries is not complicated and can be achieved if it is made a priority. In conclusion, there are multiple obstacles in regard to succeeding the highest achievable standard of health globally.  With the education of evolving scientific methods, and the collaboration of humanitarian views, the welfare and health of women and their children, can be internationally restored. With the education of evolving scientific methods, and the collaboration of humanitarian views, the welfare and health of women and their children, can be internationally restored.

scholarly journals The effectiveness of training in emergency obstetric care: a systematic literature review

2019 ◽  
Vol 34 (4) ◽  
pp. 257-270 ◽  
Author(s):  
Charles A Ameh ◽  
Mselenge Mdegela ◽  
Sarah White ◽  
Nynke van den Broek
Keyword(s):  
Clinical Practice ◽  
Maternal Mortality ◽  
Health Outcomes ◽  
Emergency Obstetric Care ◽  
Case Fatality ◽  
Obstetric Care ◽  
Team Work ◽  
Knowledge And Skills ◽  
Effectiveness Of Training ◽  
Four Levels

Abstract Providing quality emergency obstetric care (EmOC) reduces the risk of maternal and newborn mortality and morbidity. There is evidence that over 50% of maternal health programmes that result in improving access to EmOC and reduce maternal mortality have an EmOC training component. The objective was to review the evidence for the effectiveness of training in EmOC. Eleven databases and websites were searched for publications describing EmOC training evaluations between 1997 and 2017. Effectiveness was assessed at four levels: (1) participant reaction, (2) knowledge and skills, (3) change in behaviour and clinical practice and (4) availability of EmOC and health outcomes. Weighted means for change in knowledge and skills obtained, narrative synthesis of results for other levels. One hundred and one studies including before–after studies (n = 44) and randomized controlled trials (RCTs) (n = 15). Level 1 and/or 2 was assessed in 68 studies; Level 3 in 51, Level 4 in 21 studies. Only three studies assessed effectiveness at all four levels. Weighted mean scores pre-training, and change after training were 67.0% and 10.6% for knowledge (7750 participants) and 53.1% and 29.8% for skills (6054 participants; 13 studies). There is strong evidence for improved clinical practice (adherence to protocols, resuscitation technique, communication and team work) and improved neonatal outcomes (reduced trauma after shoulder dystocia, reduced number of babies with hypothermia and hypoxia). Evidence for a reduction in the number of cases of post-partum haemorrhage, case fatality rates, stillbirths and institutional maternal mortality is less strong. Short competency-based training in EmOC results in significant improvements in healthcare provider knowledge/skills and change in clinical practice. There is emerging evidence that this results in improved health outcomes.

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.

scholarly journals Etiology of Maternal Mortality at Nepalgunj Medical College

2018 ◽  
Vol 16 (2) ◽  
pp. 27-30
Author(s):  
Durga B.C. ◽  
Ganesh Prasad Neupane ◽  
Maya Rai ◽  
Aseem Sharma
Keyword(s):  
Maternal Mortality ◽  
Health Care Services ◽  
College Teaching ◽  
Public Health Problem ◽  
Obstetric Care ◽  
World Health ◽  
Maternal Deaths ◽  
Medical College ◽  
Surgical Teams ◽  
Health Organization

Introduction: Maternal mortality is an indicator of the quality of obstetric care in a community directly reflecting the utilization of health care services available. Maternal mortality has been recognised as a public health problem in the developing countries. Aim and Objective: To analyse the etiology of maternal deaths. Material and Methods: This descriptive study was conducted in the gynaecology and obstetrics department of the Nepalgunj Medical College Teaching Hospital Banke Nepal for a period of two years from august 2016-august 2018. All cases of maternal deaths in line with the definition of World Health Organization have been included. Data were collected and analyzed. Results: Twenty three (23) maternal deaths were identified during the study period. 69.56% of deaths occurred due to direct obstetric causes. Uncontrollable postpartum haemorrhage with 37.5 % was the leading cause of maternal death followed by eclampsia (18.75%) and sepsis (18.75%). Indirect causes were dominated by heart disease. Maximum 56.5% of deaths had occurred after 48 hours of admission. Conclusions: Haemorrhage, eclampsia and infections are the main causes of maternal deaths in our study. access to emergency medication, transfusion and anaesthetic and surgical teams in hospitals but also through the involvement of religious leaders, traditional and any community to better understand the population obstacles to reducing maternal mortality.

Sign in / Sign up

Export Citation Format

Share Document