Prepare and prevent rather than repair and repent: Study of maternal mortality in tertiary care hospital (original) (raw)

Maternal mortality: a retrospective analysis of 6 years in a tertiary care centre

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017

Background: Pregnancy, although being considered a physiological state, carries the risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labour or thereafter. Worldwide 3,03,000 women are dying of pregnancy related complication annually.Methods: The medical records of all maternal death occurred over a period of last five years between August 2011 to August 2017 in the Department of Obstetrics and Gynaecology at our tertiary care hospital were reviewed and analysed.Results: It is observed that out of total 30 patients, 24 (80%) deaths were from 20-30 year of age followed by 5 (16.67%) deaths from above 30 years of age. In the study period, 40% of maternal deaths were due to direct causes, haemorrhage (8/12; 66.67%) was main direct causes of obstetric death.Conclusions: The complications leading to maternal death can occur without warning at any time during pregnancy and childbirth. Most maternal deaths are preve...

A Retrospective Study of Maternal Mortality in A Tertiary Care Hospital

IOSR Journals , 2019

Introduction: Maternal mortality is defined as the death of any woman while being pregnant or within 42 completed days of termination of pregnancy, irrespective of the duration or site of pregnancy, from any cause related to or aggravated by pregnancy, but not from accidental or incidental causes.1 Maternal mortality ratio (MMR) is defined internationally as the maternal mortality rate per 1 lakh live births. Materials and Methods: A retrospective hospital based study was conducted in the Department of OBG, M.G.M Medical College, Jamshedpur, India over a period of 2 years from January, 2017 to December, 2018. All booked or unbooked maternal deaths admitted at the time of pregnancy, delivery or during puerperium were included in study. The data was collected from hospital records. The medical records sheets of all identified women were reviewed regarding age, parity, residence, antenatal booking status and cause of maternal death. Data was collected on a proforma and entered into computer using SPSS version 10 for analysis. Permission of the institutional ethical committee was obtained before recording data on proforma with the assurance of its confidentiality. Causes of death were identified as direct cause and indirect cause. Results: A total of 53 deaths were analyzed. The mortality rate in study period was 441 per 1,00,000 live births. Maximum maternal deaths were reported in the age group 20-24 years. More deaths were reported in primiparous women (49.16%) as compared to multiparous women (35.83%). Most of them were unbooked cases (56.66%). The classic triad of haemorrhage (36.66%), hypertensive disorders (23.33%) and sepsis (12.5%) were the major direct causes of maternal death. Anemia was the major indirect cause of death. Other indirect causes of maternal death were jaundice, heart disease, respiratory disease and epilepsy. Conclusion: A number of sociodemographic factors affect maternal mortality. It was observed that poor, illiterate, unbooked women coming from remote rural areas were more vulnerable to morbidity and mortality. Haemorrhage is the leading cause of maternal death followed by hypertensive disorders and sepsis. Anemia continues to be the most common indirect cause. Death due to haemorrhage can be controlled by SBA training of all nursing staff. Death due to hypertensive disorders can be reduced by early identification of PIH, use of Magnesium sulphate and early termination of eclampsia.

Analysis of Maternal Mortality in a Tertiary Care Centre: A 5 Yrs Retrospective Study

Journal of Evolution of medical and Dental Sciences, 2013

during 5 year period from Jan 2007-Dec 2011 were studied. The individual records of all maternal deaths occurring during the study period of 5 years were extracted from patient's case notes and hospital record registers. Total deliveries for the period were extracted from the delivery registers. RESULTS : In the year 2007-2011 total live births were 43,683 of which 338 mothers died giving cumulative maternal mortality ratio of 773.75 per 1,00,000 live births. Among 338 total maternal deaths, the maximum deaths were in the age group 20-30 years (88.16%).The death rate of mothers from rural areas was higher (65.68%).The highest number of maternal death occurred among multigravidae (46.74%). A total of 91.72% of maternal death occurred in unbooked patients. Most were referred patients (74.55%). Most of them were illiterate (61.8%).76.62% patients died within 24 hours of admission.33.13% women died in antenatal period while 64.49% died in postnatal period. Direct obstetric causes of death accounted for 76.03% of all maternal deaths. Among the direct causes 39.64% died due to hypertensive disorder of pregnancy, 18.93% due to hemorrhage. Indirect causes accounted for 23.96% in which anemia (8.57%), malaria (3.55%) hepatitis (2.66%) were the leading causes. CONCLUSIONS: This study has shown higher maternal mortality due to being a tertiary care hospital based study where more complicated and referred cases are admitted. Most maternal deaths can be prevented by providing care at grass root level, linkage between primary, secondary and tertiary care, strengthening of referral services and instituting emergency obstetric services. INTRODUCTION: According to World health organization: Maternal death is defined as 'Death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental causes or incidental causes(ICD 10 REVISION) [1]

A comprehensive study on maternal mortality at a tertiary care hospital

IP innovative publication pvt. ltd, 2019

Introduction: Maternal mortality, according to WHO is defined as “the death of women while being pregnant or within 42 days of termination of pregnancy, irrespective of duration and site of pregnancy, from any cause related or aggravated by the pregnancy but not from accidental or incidental cause”. Maternal death is classified as Direct and Indirect maternal death. About 99% ofMMRoccur in developing countries. Hence the present study has been taken up to analyze cause of maternal mortality in tertiary hospital. Aim: Our study aims to analyze the cause and incidence of maternal mortality in a tertiary care hospital Materials and Methods: Present Study is a, Retrospective study conducted in Cheluvamba hospital, MMC&RI which is a tertiary care hospital. We have analyzed all maternal deaths, which were reported in the institute during the study period starting from 1st January 2015 to 31st May 2019 (4 years 5 months). Results: There were 52,896 deliveries in our institute during the study period. 60 maternal deaths were reported. Maternal mortality rises with high degree of parity as noted in the study, multigravida (56.7%). 55% cases were unbooked. The major cause of death was attributed to Hypertensive disorders of pregnancy (45%) and second major cause is anemia (41.7%). Conclusion: Enhancing women’s access to basic health care facilities, regular Antenatal care, high risk pregnancy detection and its management and basic health education helps in reducing maternal mortality.

Maternal mortality at a tertiary health care: a retrospective study

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018

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.

Retrospective Review Of Data On Causes Of Maternal Deaths At Holy Family Hospital, Techiman

Introduction: The death of a woman is noted to bring economic burden to a nation. Maternal death is also recognized as Public Health Importance worldwide. This called for attention of the Millennium Declaration to feature so prominently in the high ranks of a global pronouncement, providing an opportunity to galvanize action and so help ensure that the risk of maternal death is minimized for all women (Ronsmans& Graham, 2006). Objective: The main objective was to assess and review major factors contributing to the cause of maternal mortality in Holy Family Hospital, Techiman. Methods: A retrospective cross sectional review of data of all maternal deaths audited from 2009 to 2014 were assessed and examined to determine the predominant causes of maternal deaths in that facility using a self constructed checklist for both clinical and demographic data of all the maternal deaths cases. Results: Ninety-Seven maternal deaths were recorded. During the same period a total of 34,016 live births were recorded in the hospital within the six-year period. A mean maternal death ratio of 364 /100,000 live births was also determined during the review. All the cases identified had contacted or were in contact with the health facility before their death. Conclusion: Of the 97 deaths, 67 (69%) were direct obstetric deaths of which hemorrhage was the leading cause accounting for 50(74.6%) cases. Indirect obstetric deaths were 30 (31%) Keywords: Maternal Mortality, Mortality Ratio, Partograph Usage

Maternal mortality in a tertiary care hospital

Journal of Ayub Medical College, Abbottabad : JAMC

Death of a woman during pregnancy and child birth is an extremely tragic event. It is a waste of a precious life that leaves great feeling of grief and pain for the family and hospital staff and has devastating influence on the community overall. Maternal morbidity and mortality can be prevented by awareness of reproductive health in a community, availability, and utilisation of organised antenatal care, skilled intrapartum management and careful postnatal follow up. Objective was to analyse the pattern of maternal mortality over the period of five years in a tertiary level hospital receiving high risk referred patients form periphery. All patients admitted in Gynae 'A' Unit, Ayub Teaching Hospital from January 2006 to December 2010 were included in the study and number and causes of maternal deaths were noted. During these 5 years there were 78 maternal deaths out of 11,997 obstetrical admissions. There were 7,380 total births and 78 maternal deaths during the study period ...

Comparative Study of Maternal Mortality between General and University Hospitals

IOSR Journals , 2019

Background: Reducing the maternal mortality rate in the third world countries is a challenge the approach of reducing maternal mortality has to be global, so the developed countries have a major role to play. Aim of the Work: to determine, outline, and assess the factors contributing to maternal mortality, especially the avoidable factors, and to evaluate the possibility of prevention of such factors to decrease the incidence of maternal mortality to the least possible value, and finally to make some recommendations to achieve this goal.".Results: The main causes of maternal mortality, are antepartum hemorrhage (28.2%), postpartum hemorrhage (12.8%), Accidental hemorrhage (5.1%), hypertensive disorders in pregnancy (usually eclampsia) (10.38%), organ failure (10.3%) and cardiac arrest (12.8%).Conclusion: Most common causes are postpartum hemorrhage, cardiac disorders and severe hypertensive disorders during pregnancy. Maternal mortality can be effectively avoided and prevented through improving antenatal care, emergency obstetric services and reform of internship training program.

Analysis of Maternal Death in a Tertiary Care Hospital

Journal of Shaheed Suhrawardy Medical College, 2022

Objectives: Maternal death was analyzed in Shaheed Suhrawardy Medical College hospital to improve the quality of maternal health care. Methods: In this cross -sectional study, each case was reviewed individually and factors responsible for maternal death were identified and noted. Results: During the study period January 2019 to December 2019 total 16 maternal death recorded among 3410 deliveries. 68% deceased mother were less than 30 years of age. Parity shows 37.50% multipara. 75% deceased mother was delivered by caesarean section, 6% was vaginal delivery and 12.5% mother died undelivered. Regarding time interval 25% of death occurred within 24 hours of admission to hospital. The main causes of death were severe preeclampsia- eclampsia (31.25%), PPH (12.5%), septicemia (12.5%), DIC (12.5%). Some factors were identified and among them lack of proper ANC, delayed admission to hospital, delayed blood transfusion were related. Conclusion: Substantial number of maternal death occurred ...

Risk Factors of Maternal Mortality

Journal of Rawalpindi Medical College, 2014

Background: To analyze maternal deaths, the risk factors involved and the contribution of each risk factor towards maternal mortality. Methods: In this descriptive study a complete evaluation of all maternal deaths was performed. All maternal mortalities were presented and evaluated in monthly hospital mortality meetings. Information was collected about women booking status, age, parity, socioeconomic status, distance from place of referral, and reasons for delayed referral. Women who received antenatal care at least three times in the hospital were labeled as booked and rest of patients as non booked. The causes and factors leading to maternal deaths were recorded. Results:During this period total numbers of deaths certified were 51. Out of these 8 patients were brought dead to hospital while 43 died in hospital. Direct causes were found in 41 maternal deaths (80.3%). Hemorrhage being the leading cause (31.3%) followed by hypertensive disorders of pregnancy (eclampsia) and sepsis. ...