Complications of Pregnancy

2021 ◽  
pp. 103-137
Keyword(s):  
Maternal Mortality ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Medical Abortion ◽  
Fetal Outcome ◽  
Reproductive Age ◽  
Medical Interventions ◽  
Obstructed Labour ◽  
Primary Means ◽  
Maternal Sepsis

Although the majority of pregnancies are uneventful, sometimes complications do happen. Pregnancy complications are the conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy and range from minor discomforts to serious diseases that require medical interventions. They can involve the mother's health, the baby's health, or both. Complication of pregnancy can cause maternal morbidity and mortality. The most common causes of maternal mortality are maternal bleeding, maternal sepsis, hypertensive disease, obstructed labour, and pregnancy with the consequence of abortion, which includes miscarriage, ectopic pregnancy, and medical abortion. The primary means of preventing maternal deaths is to provide rapid access to emergency obstetric care, including treatment of haemorrhage, infection, hypertension, and obstructed labour. Proper antenatal care can reduce the maternal mortality rate by reducing the number of pregnancies among women of reproductive age. Thus, adequate monitoring and appropriate intervention strategies should be provided for better maternal and fetal outcome.

From Home to Hospital: Mistreatment of Childbearing Women and Barriers to Facility-Based Birth in Nicaragua

2012 ◽  
Vol 2 (1) ◽  
pp. 40-50 ◽  
Author(s):  
Kari A. Radoff ◽  
Amy Levi ◽  
Lisa M. Thompson
Keyword(s):  
Maternal Mortality ◽  
North Atlantic ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Verbal Abuse ◽  
Women Patients ◽  
Medical Interventions ◽  
The North ◽  
Significant Barrier ◽  
Childbearing Women

Worldwide, women continue to die during childbirth despite efforts to reduce maternal mortality. Nicaragua, particularly the North Atlantic Autonomous Region (RAAN), possesses extremely high rates of maternal mortality. It has been suggested that promoting facility-based birth is an effective method to reduce maternal mortality through providing essential obstetric and emergency obstetric care to the most women. A significant barrier to increasing rates of facility-based birth globally is mistreatment of women patients in health care settings. This case report illustrates the mistreatment of childbearing women during facility-based birth in the RAAN, including verbal abuse, physical abuse, neglect, and use of unnecessary medical interventions.

scholarly journals Observational study of maternal and fetal outcome in obstetric emergencies admitted to tertiary care centre

2021 ◽  
Author(s):  
Neelima Singh ◽  
Sreedevi . ◽  
Sushma .
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Fetal Outcome ◽  
Tertiary Care Centre ◽  
Cervical Injury ◽  
Mortality And Morbidity ◽  
Obstetric Emergencies

Background: Objectives of the current study were to evaluate the risks factors, clinical presentations, the management and maternal and fetal outcome of common obstetric emergencies encountered at Government general hospital Nizamabad, Telangana, from April 2019 to November 2019.Methods: It is an Observational, hospital-based study done department of obstetrics and gynaecology in 160 cases of obstetric emergencies managed in 8 months study period were reviewed.Results: Out of 3000 deliveries there were 160 cases of obstetric emergencies giving a percentage of 5.33%. About 84% had antenatal care and 16% had not taken ANC with perinatal mortality of 91.9% in booked cases. Out of 160 cases of obstetric emergencies, obstetric haemorrhage constituted 94 (58.75%) cases and among those cases, 23 cases (24.5%) were PPH including both atonic and traumatic, abruptio placenta constituted 35 cases (37.3%). Out of 160 cases of obstetric emergencies, obstructed labour constituted 29 cases (18.1%) being a frequent indication for emergency caesarean section, 1 case of septic abortion and 30 cases eclampsia. 29 perinatal deaths giving the perinatal mortality rate as 181 per 1000 live births. One maternal mortality due to rupture uterus. Maternal morbidity was in the form of wound infections which was found in 6 cases (3.75%), wound gaping in 2 cases (1.25%) PPH in 19 cases (11.81%), septicaemia in 17 cases (10.6%), puerperal pyrexia 6 cases (3.7%), vaginal or cervical injury 6 cases (3.7%), ICU admissions in 9 cases (5.6%). This morbidity increased the number of days of hospital stay to the patients.Conclusions: In majority of cases, the complications are preventable and treatable with proper antenatal and intranatal care. Identification of high risks cases, education of people about the importance of supervised pregnancy, delivery and emergency obstetric care will reduce the maternal mortality and morbidity and perinatal mortality and morbidity significantly.

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 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 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 Post-Partum Hemorrhage is Still Killing Mothers in Bangladesh: An Observation from the 2016 Bangladesh Maternal Mortality Survey (BMMS)

2020 ◽  
Author(s):  
Aminur Rahman ◽  
Anne Austin ◽  
Tahmina Begum ◽  
Iqbal Anwar
Keyword(s):  
Maternal Mortality ◽  
Universal Access ◽  
Post Partum ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Active Management ◽  
Director General ◽  
Public And Private ◽  
Third Stage ◽  
Mortality Survey

Abstract The main cause of maternal death in Bangladesh is postpartum hemorrhage (PPH). PPH accounts for 31%of maternal deaths. Proven interventions to prevent maternal mortality are active management of third stage of labour (AMTSL) and the availability of comprehensive emergency obstetric care (CEmOC). Both of these interventions mandate the administration of oxytocin. In Bangladesh there are nonfunctioning institutionalized guidelines from the Director General of Health Services on the storage of oxytocin, which may impact the potency of oxytocin used during labour. To reduce preventable PPH morbidity and mortality, Bangladesh needs to evaluate the potency of current stores of oxytocin used in both in public and private facilities, develop and enforce protocols to ensure the potency of oxytocin, and promote universal access to quality AMSTL and CEmOC services.

scholarly journals Perceptions of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone

2020 ◽  
Author(s):  
R. Proos ◽  
H. Mathéron ◽  
J. Vas Nunes ◽  
A. Falama ◽  
P. Serry-Kamal ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Maternal Mortality ◽  
Sierra Leone ◽  
Health Care Workers ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Obstetric Complications ◽  
Care Workers

Abstract BackgroundSierra Leone has one of the highest maternal mortality ratios in the world. Timely and well-coordinated referrals are necessary to reduce delays in providing adequate care for women with obstetric complications. This study describes the perspectives of health workers in rural facilities in Sierra Leone concerning the referral of women with obstetric complications.MethodsWe conducted semi-structured group interviews with health care workers in nine peripheral health units in rural Sierra Leone regarding the referral of women with obstetric complications. Themes discussed were based on an interview guide. The data was analysed by systematic text condensation.ResultsPerspectives were grouped according to the following themes identified: 1) communication between health care workers; 2) underlying influences on decision-making; 3) women’s compliance to referral; 4) logistic constraints.ConclusionSeveral factors in rural Sierra Leone are perceived to complicate timely and adequate referral of women in need of emergency obstetric care. Notable among these factors are fear among women for being referred and fear among health care workers for having maternal deaths or severe obstetric complications at their own facilities. Furthermore, the decision-making of health care workers concerning referral is negatively influenced by an atmosphere of hierarchy between health care workers. Such factors must be considered in efforts to reduce maternal mortality.

Sign in / Sign up

Export Citation Format

Share Document