scholarly journals Eclampsia: A Well Preparedness Can Save the Day

2021 ◽  
pp. 106-109
Author(s):  
Kirti Gujarkar Mahatme ◽  
Pratibha Deshmukh ◽  
Priyanka Deshmukh ◽  
Shiliveri Sadhan Siddardha
Keyword(s):  
Maternal Mortality ◽  
Healthcare System ◽  
Pregnant Female ◽  
Fetal Mortality ◽  
Late Referral

Maternal mortality is one of the indicators of an efficiently working healthcare system. Eclampsia is one of the preventable causes of maternal mortality and thus it is important to identify the signs in the preeclampsia phase and treat it efficiently to prevent the mishap. Many times, the detection of eclampsia is delayed due to improper history, late referral, ignorance, and delay in transportation or hospitalization. This report presents a 22 yr. old pregnant female, who presented to the hospital and before considering her for admission and shifting to ward, she threw convulsions. This report emphasizes on successful and timely management of such cases and the precautions which help to reduce maternal and fetal mortality.

scholarly journals Evaluation of maternal and fetal outcome in pregnancies complicated by jaundice-an observational study

2021 ◽  
Author(s):  
Ruchi Kishore ◽  
Neha Thakur ◽  
Mitali Tuwani
Keyword(s):  
Mortality Rate ◽  
Observational Study ◽  
Maternal Mortality ◽  
Viral Hepatitis ◽  
Hellp Syndrome ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Fetal Mortality ◽  
Maternal Mortality Rate ◽  
In Pregnancy

Background: The spectrum of jaundice in pregnancy varies from a benign condition with good maternal and fetal outcome to a severe form resulting in liver failure and maternal and fetal mortality. Jaundice may complicate 3-5% of pregnancies. Present study was aimed to analyze the cause, course and impact of jaundice during pregnancy so as to have better understanding and hence better feto-maternal outcome. The present study aimed to analyze the various causes of hepatic dysfunction in pregnancy, maternal and fetal outcome in pregnancies complicated by jaundice and various hematological and liver function variables for predicting maternal and fetal outcome.Methods: The present study was an observational study conducted in the department of obstetrics and gynecology, Pt. JNM medical college and associated Dr. BRAM hospital, Raipur (CG) over period of 2 year from September 2018 to September 2020.Results: Total 0.72% pregnancies were complicated by jaundice. HELLP syndrome was the commonest cause of jaundice in pregnancy (36.7%), followed by viral hepatitis (32.7%). Hepatitis E was the most common type of viral hepatitis (91.8%). Hemolytic jaundice presented with best maternal outcome (maternal mortality rate 8.6%). Worst maternal outcome was seen in AFLP (maternal mortality rate 100%). Best fetal outcome was seen in viral hepatitis (live birth rate 67.6%), whereas worst noted with AFLP (fetal death rate 66.6%). Higher total serum bilirubin, higher serum AST, anemia and deranged INR had significant correlation with maternal mortality.Conclusions: HELLP syndrome and viral hepatitis are preventable causes of jaundice yet it contributed to significant proportion of maternal deaths in 26.5 and 18.5% cases respectively. AFLP is often under diagnosed and had a fulminant course in pregnancy causing maternal and fetal mortality.

scholarly journals Maternal complications and risk factors for mortality

2020 ◽  
Author(s):  
Sulis Diana ◽  
Chatarina Umbul Wahyuni ◽  
Budi Prasetyo
Keyword(s):  
Risk Factors ◽  
Nutritional Status ◽  
Maternal Mortality ◽  
Occupational Status ◽  
Simple Random Sampling ◽  
Dominant Factor ◽  
Childbearing Age ◽  
Maternal Complications ◽  
History Of ◽  
Late Referral

Background: Maternal mortality could be prevented through early detection, including the period preceding pregnancy. Women of childbearing age are faced with extreme uncertainties, hence the purpose of this study was to analyse maternal complications and the possible high-risk factors connected to maternal mortality.Design and methods: A case-control study was used to study the causes of maternal mortalities amongst pregnant, delivering, and postpartum mothers between 2017 and 2018. A total sample size of 48 samples was selected through simple random sampling. Results: The result of logistic regression analysis showed nutritional status, prominence of anemia, history of illness, age, antenatal care ANC examination, method of delivery, late referral, occupational status, as well as postpartum complications, as the most influencing risk factors. This very high significance for maternal mortality was based on the chi-square value of 109.431 (p equal to 0.000), and R square (0.897). Conclusions: In conclusion, the potential risk factors of maternal mortality include nutritional status, state of anemia, history of illness, age, ANC examination, delivery method, late referral, occupational status, and pregnancy complications, which is specifically the most dominant factor.

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 Mortality Risk Factor 2016 in Aceh Province

2018 ◽  
Vol 5 (6) ◽  
pp. 4776-4780 ◽  
Author(s):  
Nurlaili Ramli ◽  
Eva Purwita Purwita
Keyword(s):  
Decision Making ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Health Facilities ◽  
Maternal Deaths ◽  
Access To Health ◽  
Key Word ◽  
Aceh Province ◽  
Late Referral ◽  
Main Factor

The studies goals was determine the cause of death from 3 factor of delaying that are the delaying in decision making, delaying in reaching health facility and delaying of getting  adequate service  in the health facilities. The study was conducted in 9 district /cities representing eastern, western and central in Aceh province and there was maternal mortality. Research start from April to Oktober 2016. The sample was all the mothers who experience death in 9 district/cities amounted to 45. Research instrument in the form of quistioner given to family, midwife, midwife coordinator and village head. Research design is deskriptif explorative. Maternal deaths 57.7% were used by bleeding during the pregnancy/childbirth. The mayority maternal death sare due to delays that occurring during pregnancy/childbirth, postpartum, either late in decision making (97.8 %), late referral (95.6%) and delayed access to health facilities (91.1%). Decision making by head of family is influenced by traditional beliefs so that it is the main factor of maternal mortality. Key word : Maternal death, late in decision making, late referral, delayed access ro health facilities.

scholarly journals Analysis of causes of maternal mortality in tertiary care center, 11 years study

2021 ◽  
Vol 10 (9) ◽  
pp. 3320
Author(s):  
Vandana R. Saravade ◽  
Munira Ansari ◽  
Ganesh Shinde
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Care Center ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Hepatitis Infection ◽  
Mortality Ratio ◽  
Late Referral ◽  
Timely Treatment

Background: Objectives to study the causes of maternal mortality and the complications leading to maternal death.Methods: A retrospective study of hospital records and death summaries of all maternal death over a period of 11 years from January 2008 to December 2018 was carried out at tertiary care hospital, Mumbai.Results: There were a total of 459 maternal death out of 36930 live birth giving maternal mortality rate mean maternal mortality ratio (MMR) of 1242 per 100000 live births. Unregistered and late referral account for maternal death. The majority of women were in 21-30 years age group in 20 to less than 37 weeks of pregnancy. The commonest cause of death was due to hepatitis infection 129 (28.1%), sepsis 52 (11.32%), PIH including eclampsia 46 (10.02%), cardiovascular diseases 33 (7.18%), haemorrhage 31 (6.75%), Kochs 31 (6.75%) and respiratory diseases 22 (4.79%).Conclusions: Maternal mortality can be reduced by identifying causes which are preventable and giving timely treatment.

scholarly journals Near Miss Obstetric Events and Maternal Death: Experience in Combined Military Hospital, Dhaka

2019 ◽  
Vol 14 (1) ◽  
pp. 37-40
Author(s):  
Nasrin Ara Zaman ◽  
Khondaker Shahidul Ghani ◽  
Maj Umme Ruman
Keyword(s):  
Intensive Care ◽  
Maternal Mortality ◽  
Critically Ill ◽  
Emergency Services ◽  
Maternal Mortality Ratio ◽  
Near Miss ◽  
Safe Motherhood ◽  
Military Hospital ◽  
Fetal Mortality ◽  
Hypertensive Disorder

Introduction: Obstetric patients can become critically ill for pregnancy related complications other conditions unrelated to pregnancy and may require emergency intensive care. The survival of both the mother and baby depends on the emergency services that are provided at that critical moment. Objective: To evaluate the level of obstetric emergency services in Combined Military Hospital (CMH) Dhaka by comparative analysis of near-misses and mortalities. Materials and Methods: This descriptive cross-sectional study which was conducted by observation of critically ill obstetric patients admitted in general intensive care unit (ICU) of CMH Dhaka from July 2012 to June 2013. Data regarding the disease associated with pregnancy and complications requiring ICU admission or transfer were collected and analyzed to calculate the maternal mortality and near miss ratio. Results: During the study period, 44 cases have been shifted to ICU, representing 2.15% of 2050 deliveries. Haemorrhage (50%) and hypertensive disorder of pregnancy (36.36%) were the two main obstetrical complications requiring ICU management. Surgical intervention was required in 86.3% of cases, 68% required intensive monitoring in ICU followed by blood transfusion in 59% cases. The maternal mortality ratio was 195.12/100000 live birth and fetal mortality rate was 82.2 per 1000 deliveries. Conclusion: By adopting safe motherhood initiative, both morbidity and mortality of pregnant mother can be lowered down. Early diagnosis by assessment, prompt intervention by team of expert obstetricians, intensivist and anaesthetist in reserve ICU can reduce the maternal mortality and morbidity. Journal of Armed Forces Medical College Bangladesh Vol.14(1) 2018: 37-40

scholarly journals Risk Factors for Maternal and Fetal Mortality in Acute Fatty Liver of Pregnancy and New Predictive Models

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhaoli Meng ◽  
Wei Fang ◽  
Mei Meng ◽  
Jicheng Zhang ◽  
Qizhi Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Maternal Mortality ◽  
Predictive Models ◽  
Multivariate Logistic Regression Analysis ◽  
Fetal Mortality ◽  
Multivariate Logistic Regression ◽  
Acute Fatty Liver ◽  
Independent Risk Factors

Acute fatty liver of pregnancy (AFLP) is a rare but potentially life-threatening hepatic disorder that leads to considerable maternal and fetal mortality. To explore the risk factors for maternal and fetal mortality in AFLP and develop new predictive models, through this retrospective study, we analyzed the demographic characteristics, clinical symptoms, and laboratory findings of 106 patients with AFLP who were admitted to Shandong Provincial Hospital. Risk factors for maternal and fetal mortality were analyzed by univariate and multivariate logistic regression analysis. The new models based on the multivariate logistic regression analysis and the model for end-stage liver disease (MELD) were tested in AFLP. The receiver operating characteristic curve (ROC) was applied to compare the predictive efficiency, sensitivity, and specificity of the two models. Prenatal nausea (p = 0.037), prolonged prothrombin time (p = 0.003), and elevated serum creatinine (p = 0.003) were independent risk factors for maternal mortality. The ROC curve showed that the area under the curve (AUC) of the MELD was 0.948, with a sensitivity of 100% and a specificity of 83.3%. The AUC of the new model for maternal mortality was 0.926, with a sensitivity of 90% and a specificity of 94.8%. Hepatic encephalopathy (p = 0.016) and thrombocytopenia (p = 0.001) were independent risk factors for fetal mortality. Using the ROC curve, the AUC of the MELD was 0.694, yielding a sensitivity of 68.8% and a specificity of 64.4%. The AUC of the new model for fetal mortality was 0.893, yielding a sensitivity of 100% and a specificity of 73.3%. Both the new predictive model for maternal mortality and the MELD showed good predictive efficacy for maternal mortality in patients with AFLP (AUC = 0.926 and 0.948, respectively), and the new predictive model for fetal mortality was superior to the MELD in predicting fetal mortality (AUC = 0.893 and 0.694, respectively). The two new predictive models were more readily available, less expensive, and easier to implement clinically, especially in low-income countries.

scholarly journals An Analysis of Maternal Death’ Cause in Bandung City (Epidemiology Study in Efforts to Lower Maternal Mortality Rate in West Java Province)

2020 ◽  
Vol 9 (2) ◽  
pp. 1370-1379
Author(s):  
Hartinah Hartinah ◽  
Innama Sakinah ◽  
Tita Husnitawati Madjid ◽  
Hadi Susiarno ◽  
Sukandar Hadyana ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Epidemiology Study ◽  
Factors Associated ◽  
Danger Signs ◽  
History Of ◽  
Low Levels ◽  
Level Of Understanding ◽  
Late Referral ◽  
In Pregnancy

The results showed that the factors associated with maternal mortality based on the analysis were history of ANC (OR = 37.4; 95% CI: 9.5 - 313.6; p = 0.012), place of death (OR = 21.5; 95% CI: 2.5 - 188.5; p = 0.001), Health Facility (OR = 21.5; 95% CI: 2.5 - 188.5; p = 0.001), Non-referral case (OR = 91.2; 95% CI: 11.1 - 750; p = 0.001), delay in referral (OR = 122.1; 95% CI: 14.7 - 1010.2; p = 0.001). The results of the qualitative study showed that maternal mortality was affected by several factors, such as the low level of understanding of danger signs in pregnancy, labor and childbirth, low levels of late referral by overdue family decisions. 

scholarly journals Cesarean Section and Maternal-fetal Mortality Rates in Nigeria: An Ecological Lens into the Last Decade

2020 ◽  
Vol 9 (1) ◽  
pp. 128-135
Author(s):  
Hadiza Galadanci ◽  
Deepa Dongarwar ◽  
Wolfgang K ◽  
Oladapo Shittu ◽  
Murtala Yusuf ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Maternal Mortality ◽  
Vaginal Delivery ◽  
Mortality Rates ◽  
Significant Rise ◽  
Fetal Mortality ◽  
Maternal Deaths ◽  
Spontaneous Vaginal Delivery ◽  
The Sustainable Development ◽  
Global Average

Background or Objectives: Despite the global decline in maternal mortality within the last decade, women continue to die excessively from pregnancy-related complicationsin developing countries. We assessed the trends in maternal mortality, fetal mortality and cesarean section (C-Section) rates within 25 selected Nigerian hospitals over the last decade. Methods: Basic obstetric data on all deliveries were routinely collected by midwives using the maternity record book developed for the project in all the participating hospitals. Trends of C-Section Rates (CSR), Maternal Mortality Rates (MMR), Fetal Mortality Rates (FMR) and Spontaneous Vaginal Delivery rates (SVD) were calculated using joinpoint regression models. Results: The annual average percent change in CSR was 12.2%, which was statistically significant, indicating a rise in CSR over the decade of the study. There was a noticeable fall in MMR from a zenith of about 1,868 per 100,000 at baseline down to 1,315/100,000 by the end of the study period, representing a relative drop in MMR of about 30%. An average annual drop of 3.8% in FMR and 1.5% drop in SVD over time were noted over the course of the study period. Conclusion and Global Health Implications: We observed an overall CSR of 10.4% and a significant rise in CSR over the 9-year period (2008-2016) of about 108% across hospital facilities in Nigeria. Despite the decrease in MMR, it was still high compared to the global average of 546 maternal deaths per 100 000 livebirths. The FMR was also high compared with the global average. The MMR found in this study clearly indicates that Nigeria is far behind in making progress toward achieving the Sustainable Development Goal 3 (SGD 3) which aims to reduce the global MMR to less than 70 per 100 000 live births by 2030. Key words: • Cesarean section • Maternal mortality • Fetal mortality • Spontaneous vaginal delivery • Trends in MMR • Nigeria   Copyright © 2020 Galadanci et al. This is an open-access article distributed under the terms of the Creative Com - mons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  

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