A five years retrospective analytic study of maternal deaths at tertiary care centre, Gujarat, India (original) (raw)
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A study on maternal mortality in a tertiary care center in South India
IP innovative publication pvt. ltd, 2019
Introduction: Maternal mortality has long been considered as a very good indicator for healthcare quality provided. Pregnancy is considered to be a physiological phase in the lifetime of a woman carrying serious implications on morbidity and mortality. It has been agreed upon that many of the maternal deaths in developing countries can be prevented. Aim: To study the prevalence of maternal mortality between March 2014-March 2018 in our hospital. Methods and Materials: It’s a retrospective observational study done at a tertiary care centre in southern part of India. Maternal deaths from March 2014 to March 2018 were looked into. Maternal mortality ratio and causes for the maternal deaths were analyzed and compared. Demographic details were collected and data regarding parity, mode of delivery, gestational age at delivery, antenatal check-ups, co morbid conditions, causes of death were noted and neonatal outcomes were noted. Results: Overall live births in the period between March 2014-March 2018 were 18978, of which the number of LSCS were 9590(50.5%), the number of vaginal deliveries were 9388(49.5%), the number of maternal deaths were 39(MMR-205/100000 live births).The leading cause was sepsis 48.6% followed by postpartum hemorrhage (20%). The most common indirect cause was anemia (42.85%). Conclusion: Sepsis & hemorrhage emerged as the greatest killers. Many of the reasons of maternal mortality were found to be preventable. Early identification and stratification of risks with prompt initiation of necessary management measures are necessary to prevent these deaths.
Maternal mortality: a tertiary care hospital experience in Upper Egypt
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 Women Health Hospital, Assiut University, Egypt, and to identify the avoidable ones. Methods: Data were collected from records of patients who presented to and/or delivered at Women Health Hospital between 2009 and 2014. Only cases of maternal mortality were included in this study. In our study, we found 213 maternal deaths at our hospital between 2009 and 2014. Results: The maternal mortality ratio decreased progressively from 2009 to 2014 (228 and 89 per 100000 live birth respectively). Moreover, we found that the indirect causes of maternal mortality accounted for 24.9 % of all mortalities. As regards the direct causes of maternal mortality, preeclampsia remained the primary cause and represented 27.7 % of the avoidable causes. The second most frequent cause of direct maternal mortality was postpartum hemorrhage (PPH), which represented 26.8 %. 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.
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.
Journal of the Turkish German Gynecological Association, 2018
The study was undertaken to understand the causes and circumstances of maternal deaths in West Bengal. One hundred ten maternal deaths were reported during the period December 2010 through June 2012 in the Maternity Ward of Medical College and Hospitals, West Bengal. These deaths were reviewed using Facility based Maternal Death Review protocol. The number and percentages were calculated and binary logistic regression analysis was performed. Majority of the deaths occurred in the 20-24 year age group, belonging to the Hindu religion, in the first and second gravida and the postpartum period. One third of mothers had the caesarean section. A majority of deaths were among referred cases (78.2 percent). Eclampsia (29.1 percent) was the leading cause of maternal death. Approximately half of the deceased women sought care after 10 hours of developing complications. More than one-third of maternal deaths were registered with type 1 delay. Our study demonstrates that the maternal deaths oc...
2015
Introduction: 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, labor or thereafter. Maternal death has serious implications for the family, the society, and the nation. Maternal mortality is universally considered as human development indicator in a country and determines the health status of the people. Method: A retrospective hospital-based study of 65 maternal deaths was conducted over a period of 1-year from January 2014 to December 2014 in respect to maternal age, parity, booking status, residence, referral, socioeconomic class, admission death interval, and cause of death. Result: Over the study period, there were 6277 deliveries, 5761 live births, giving a maternal mortality ratio of 1035 per 100,000 live births. Eclampsia was the leading direct cause and anemia the leading indirect cause. The age group of 20 to 30 years was cruci...
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.
Facility-based review of 296 maternal deaths at a tertiary centre in India: Could they be prevented?
Journal of Obstetrics and Gynaecology Research, 2013
Aims: The aim of this study was to identify causes of maternal mortality at the facility and to assess the standard of care, deficiencies in health services and preventability of these deaths using facility-based maternal death reviews. Material and Methods: This was a prospective study at a tertiary care hospital that included all women who died during pregnancy or within 42 days of being pregnant during 2005-2010. Results: A review of 296 maternal deaths revealed that 59% of these occurred in medical wards. Indirect maternal deaths (54%) outnumbered the direct deaths (46%). Main causes were hepatitis (18%), hemorrhage (10%) and puerperal sepsis (10%). Only 5% of the women had received antenatal care at the facility. One-third (34%) were referred from other centers. The majority (74%) were critically sick at admission. Most of the women (62%) died postpartum. Substandard care and deficient health services were identified in 8% and 20% of the cases, respectively. Sixteen (5%) maternal deaths were deemed preventable and another 36 (12%) possibly preventable. Since most of the preventable deaths (12/16) were due to hemorrhage, measures to control postpartum hemorrhage were promoted at the facility. Findings of the maternal death reviews were regularly conveyed to the State Health Department for prioritization and resource allocation to prevent maternal mortality. Conclusion: More maternal deaths occurred in the medical than in the obstetrics wards at the facility. The leading causes were hepatitis, hemorrhage and puerperal sepsis. Most of the deaths were non-preventable as the women were critically sick at admission; however, substandard care and health service deficiency were contributory in some of the cases.
Maternal mortality in a tertiary care hospital: a five-year review
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: This study was aimed at analyzing the maternal mortality ratio over five years, the causes leading to maternal deaths in a tertiary care hospital and factors which are preventable.Methods: The records of maternal death from August 2010 to July 2015 (5 years) were collected and analyzed. Various factors like maternal age, parity, literacy, place of residence, antenatal registration, admission-death interval, mode of delivery and causes of deaths were reviewed.Results: The mean maternal mortality ratio (MMR) was 1039. The direct causes of maternal mortality were hemorrhage (22.4%), eclampsia (21.2%), sepsis (18.78%) and amniotic fluid embolism (8.48%). Indirect obstetric deaths were due to hepatitis (10.9%), anemia (3.6%), respiratory diseases (6.06%), heart diseases (3.03%), CNS disease (5.45%). Most of the deaths (69.7%) occurred in age group 20 and30 years. 63.6% were multigravida and 85.4% were unbooked cases.Conclusions: Antenatal care, screening and management of hi...
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...