Third delay of Maternal Mortality in a tertiary hospital (original) (raw)
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One Year Analysis of Maternal Deaths at Liaquat University Hospital Hyderabad
Journal of Liaquat University of Medical & Health Sciences, 2007
DESIGN: Descriptive case series. SUBJECTS AND METHODS: Case records of all maternal deaths were reviewed for the demographic features, parity/ booking status and other risk factors. Frequencies and percentages were calculated by using SPSS 10.0 in this regard. RESULTS: During this study period, there were 3011 maternity admissions with 2786 live births. Among them, 43 maternal deaths were recorded with maternal mortality ratio (MMR) of 1543 per 100,000 live births. Majority of cases (88.3%) were unbooked, belonged to age group >25-<35 years with parity <4. Most of patients (90.6%) were anemic with hemoglobin% <10 gm/dl. Most common risk factors found were hypertensive disorders (30.2%), hemorrhage (20.9%) and sepsis (18.6%) respectively. Third phase delay appeared as the most frequently observed delay (62.7%). CONCLUSION: Maternal mortality is very high in our set up due to multiple interrelated factors. This analysis depicts the fact that many of the deaths could have been avoided if appropriate care has been offered to them. Hemorrhage, sepsis and hypertensive disorders are still the leading factors which need top priorities to be focused on. These maternal deaths can be reduced by promoting health awareness, enhancing women's participation in the antenatal program and providing them effective obstetric care at doorstep.
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 ...
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.
A five years retrospective analytic study of maternal deaths at tertiary care centre, Gujarat, India
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Maternal mortality is one of the major challenges which face the developing countries throughout the world. The aim of the study is to assess the causes of maternal mortality at P.D.U. Medical College, and to identify the avoidable ones. Methods: Data were collected from records of patients who presented to and/or delivered at P.D.U. Medical College between 2011 and 2015. Only cases of maternal mortality were included in this study. In our study, we found 120 maternal deaths at our hospital between 2011 and 2015. Results: We found that the indirect causes of maternal mortality accounted for 29.3% of all mortalities. The leading cause of death in the 5 years was uncontrollable postpartum haemorrhage (23.3%), preeclampsia with its complications (15.8%), Anemia (14.1%), Abruption placentae 12.5% and Septicaemia 5% .Direct maternal deaths accounted for 70.7%. Conclusions: Preeclampsia and PPH, as well as their complications are the leading causes of death in one of the biggest tertiary care university hospitals in Egypt. However, there are other important avoidable predisposing factors that should be dealt with including lack of patient education, delayed transfer from other hospitals, and substandard practice.
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 causes of maternal mortality in tertiary care center, 11 years study
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2021
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 tr...
Retrospective Analysis of Maternal Mortality at a Tertiary Care Hospital of Peshawar, Pakistan
2015
OBJECTIVE: To determine the frequency of maternal mortality and identify causes with age groups in tertiary care hospital of Peshawar, Pakistan. METHODOLOGY: A descriptive study conducted at Gynecology & Obstetrics units of Lady Reading Hospital, Peshawar, Pakistan. with ret- rospective review of validated records of hospital registers from January 1st January 2009 to 31st December 2011. Convenience sampling used to access the records. A self structured proforma designed to collect validated data on variables (age, cause of death, year of death, place of residence), that were analyzed in Excel- 2007 and trend analysis determined by Joinpoint Analysis Software. RESULT: A total of 277 maternal deaths recorded from Lady Reading Hospital in three years. Hemorrhage remains the leading cause with 27.07% (CI= 0.66, SD= 5.65) followed by eclampsia 15.88 % (CI= 0.60, SD= 5.13), ruptured uterus 10.83% (CI= 0.51, SD= 4.35) and sepsis 10.10% (CI= 0.47, SD= 4.04). Maximum maternal deaths of 33.5...
Indian Journal of Obstetrics and Gynecology Research, 2020
Introduction: Pregnancy is not a disease state but sometimes it leads to severe morbidity and carries risk for mortality. Maternal death not only affect family but it also has an impact on society as well as nation. Maternal mortality rate is reflection of the quality of health care services provided by the country to the women population. Materials and Methods: This is a retrospective study of maternal deaths using facility based maternal death review forms supplied by Ministry of Health and Family Welfare Government of India filled by doctor on duty at that time as a baseline document. Results: This study shows that major cause of maternal mortality in tertiary care centre was hypertensive disorders of pregnancy however hypertensive disorder of pregnancy alone was not the only cause of maternal death, it was complicated with different other causes like ARDS, APH, HELLP syndrome, PPH, Sickle cell disease, ARF, DIC, severe Anaemia and many others. Hypertensive disorders of pregnancy contributed 33% of all deaths whereas Sepsis (12%), Hepatitis (10%), Haemorrhage (8%), Heart Disease (7%), Anaemia (5%), ARDS (5%), Sickle Cell Crisis (4%), Amniotic Fluid Embolism (2%), Diabetes Mellitus (2%) and others (12%). Conclusion: Most maternal deaths are preventable by optimum antenatal, intranatal and postnatal care. Early referral of high risk pregnancies to tertiary care centre will definitely change the outcome.
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]
Background: Avoiding maternal deaths is possible even in resource-limited countries, but r correct information on which to base maternal health programmes is required. Knowing the level of maternal mortality is not enough to prevent further deaths; there is need to understand the underlying factors that led to the deaths. Maternal death review is one of the oldest and the most documented methods that can be effective in improving emergency obstetric care and maternal outcomes. Objectives: To study the maternal deaths in a District level tertiary health care unit so as to find the determinants of maternal mortality and suggest local solutions. Methods: Maternal deaths occurring in a tertiary care district hospital were analysed using maternal death review form. Socio demographic profile, antenatal care, labour and delivery parameters and cause of death was studied. Analysis was done using computer software stata. Results: In the present study there were 12 maternal deaths among 4953 deliveries giving a Maternal Mortality ratio of 242.27 per 1,00,000 live births. Pulmonary embolism was the leading cause of death complicating obstetric disorders of pregnancy induced hypertension and eclampsia. Most of the women died in the postpartum period. The affected population was rural, illiterate and belonged to the 19-29 years age group. Conclusions: Maternal death review is an important tool for delineating the causes of maternal deaths and finding cause specific and need based local solutions for curtailing maternal mortality.