scholarly journals Maternal Mortality and Associated Factors in a Tertiary Care Center of Western Nepal

2017 ◽  
Vol 5 (2) ◽  
pp. 58-63
Author(s):  
Junu Shrestha ◽  
Sangeeta Gurung ◽  
Ashika Shrestha ◽  
Anjali Subedi

Introduction: Identifying the cause of maternal death is important. The aim of this study was to determine the causes of maternal deaths and the factors associated with it. Methods: This was an observational, cross-sectional, analytical study conducted at Department of Obstetrics and Gynecology, Manipal Teaching Hospital from July 2013 to June 2017. Women who died during pregnancy, delivery, or puerperium were included in the study. Demographic factors, clinical profile, cause and type of maternal deaths were noted by taking history and by inquiring with the medical personnel involved in managing patients.  Data analysis was done using SPSS version 16. Results: There were 15 maternal deaths and 9923 livebirths. The maternal mortality ratio was 151 per 100,000 live births. Mean age of mothers was 28 years (SD = 7.5). Most of them were from rural areas, had low educational status. The mean gestational age at time of death was 33 weeks (SD = 7.5). Most of deaths (73%, n = 11) occurred in the postnatal period and 60% (n = 9) were critical at presentation. Direct obstetric causes like eclampsia was the most common (26.7%, n = 4) direct obstetric cause and cardiac disease was one of the important indirect cause (13.3%, n = 2). Delay in seeking health care and delay in reaching health center was the major reason for maternal deaths. Conclusion: Maternal mortality were mostly associated with direct obstetric causes, eclampsia being the most common. Most of the deaths were associated with delay in seeking health care and reaching health care centers.

Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat

Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.


Author(s):  
Ganesh Balasaheb Bharaswadkar ◽  
Murlidhar L. Kurtadikar

Background: Analysing the factors related to maternal mortality is very important as they reflect the socioeconomic status and health care facility availabilities of the country. This study is aimed to analyse the epidemiological aspects and different causes of maternal death and evaluation of preventable factors and unavoidable factors if any causing maternal death.Methods: The retrospective study was carried out at GMCH, Aurangabad during the period from February 2002 to January 2004. All the data related to epidemiological factors and causes of maternal mortality was recorded and analyzed.Results: There were 33 maternal deaths during the study period. The mean maternal mortality rate was 211 per 1,00,000 total births. Maximum maternal deaths were reported at the age group of 26-30 years (36.1%), in primiparous women (46.8%) and from rural areas (78.38%). Most of the deaths (37.5%) were reported within first 24 hours of hospital admission at postpartum stage (87.5%). 84.37% of maternal deaths were due to direct causes. And toxemia of pregnancy (39.5%) was major direct cause. Anaemia and infective hepatitis constitutes for 9.3% each for the indirect causes maternal death.Conclusion: Most maternal deaths can be preventable by multidisciplinary approaches involving mass community education, improving sanitation, early referrals to tertiary care centres and by providing health care facilities in rural areas.


Author(s):  
Juhi Ankit Patel ◽  
Kanaklata D. Nakum ◽  
Aditi Vithal ◽  
Mayank R. Lunagariya

Background: Epidemiological data pertaining to maternal mortality is valuable in each set up to design interventional programs to favourably reduce the ratio. This study was done to evaluate the maternal mortality rate in our hospital, to assess the epidemiological aspects and causes of maternal mortality, and to suggest recommendations for improvement.Methods: This was a 2-year retrospective study. Epidemiological data was collected from the Last 2 years of Facility Based Maternal Death Review Form. Maternal mortality ratio, epidemiological factors and causes affecting maternal mortality were assessed.Results: A total of 72 maternal deaths occurred. Most maternal deaths occurred in the age group of 20–24 years (40.27%), multiparous women (70.83%), women from rural areas (65.27%), illiterate women, unbooked patients (83.33%), and patients of low socioeconomic status. Direct causes accounted for 62.4% of maternal deaths where as 37.4% of maternal deaths were due to indirect causes.Conclusions: There is a wide scope for improvement as a large proportion of the observed deaths could be preventable.


2021 ◽  
Author(s):  
Sarita Sitaula ◽  
Tulasa Basnet ◽  
Ajay Agrawal ◽  
Tara Manandhar ◽  
Dipti Das ◽  
...  

Abstract Background:Maternal mortality ratio is an important public health indicator that reflects the quality of health care services. The prevalence is still high in developing countries than in the developed countries. This study aimed to determine the MMR and to identify the various risk factors and causes of maternal mortality.Methods: This is a retrospective study conducted in a tertiary care center of Eastern Nepal from 16th July,2015 to 15th July 2020. Maternal mortality ratio per 100,000 live-births over 5 years of study period was calculated. The causes of death, delays of maternal mortality and different sociodemographic profiles were analyzed by descriptive statistics.Results:There were total of 55,667 deliveries conducted during the study period. The calculated maternal mortality ratio is 129.34 per 100,000 live-births in year 2015 to 2020. The mean age and gestational age of women having maternal deaths were 24.69 ±5.99 years and 36.15± 4.38 weeks of gestation respectively. The common causes of maternal deaths were obstetric hemorrhage, hypertensive disorder of pregnancy and sepsis. The leading contributory factors to the death were delay in seeking health care and delay in reaching health care facility (type I delay:40.84%).Conclusions:Despite the availability of comprehensive emergency obstetric care at our center, maternal mortality is still high and almost 75% of deaths were avoidable. The leading contributory factors were due to delay in seeking care and delayed referral from other health facilities. Contributory factors related to maternal mortality are preventable through combined safe motherhood strategies, prompt referral, active management of labor and puerperium.


2021 ◽  
pp. 1-2
Author(s):  
B. Harika ◽  
Bhavishya Gollapalli

Background: Maternal Mortality is a critical indicator to assess the quality of services provided by a health care system.The concept of severe acute maternal morbidity (SAMM) has been found to complement the assessment of maternal health services, since pregnant women’s health status is not reflected by mortality indicators alone . Maternal near miss cases are more common than maternal deaths. Methods: A Retrospective analysis of maternal near miss cases and maternal deaths was undertaken in the Department of Obstetrics and Gynaecology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh over a period of two years. This study was conducted to find out maternal near miss and maternal deaths. Results: There were 2000 deliveries, 66 MNM cases and 2 maternal deaths during the study period. The Maternal Near Miss Incidence Ratio (MNMIR) ratio was 33%.The maternal near miss to mortality ratio was 33% for each maternal death. The Maternal Mortality Ratio (MMR) was 100 per 1 lakh live births in our study. Conclusion: We suggest near miss approach to evaluate and improve the quality of care provided by the health care system. By reviewing the near miss cases we can learn about the processes and their deficiencies that are in place for the care of pregnant women.


2016 ◽  
Vol 30 (2) ◽  
pp. 92-97
Author(s):  
Arife Simsek ◽  
Seyfettin Uludag ◽  
Ali Benian ◽  
Abdullah Tuten

Objective(s): The aim of this study is to evaluate frequency and nature of maternal deaths and maternal near-miss cases in a tertiary care hospital.Materials and Methods: A retrospective examination was conducted on records of the16.612 women who delivered in a tertiary care center, over a ten-year period (1997-2006). The flow chart recommended by Say et al was used in the analysis of the maternal near-miss cases.Results: The ratios of mortality related with pregnancy, maternal mortality and maternal nearmiss were 68.11/100.000, 61.29/100.000 and 17.09/1000, respectively. The ratio of maternal near- miss to maternal mortality was 27.8 and the mortality index was 3.46%. Hypertensive disorders were the leading cause of maternal deaths and maternal near-miss events.Conclusion: Hypertensive disorders were still leading cause of maternal deaths and maternal near-miss events.Absence of antenatal care and disrupted referral chains were major problems.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 92-97


Author(s):  
Jayasree Hansda ◽  
Debobroto Roy ◽  
Krishnapada Das ◽  
Manojit Sarkar ◽  
Rumpa Das ◽  
...  

Background: Maternal mortality is a tragic event as family revolves around a mother. The deadly obstetrical triad of hemorrhage, preeclampsia and infection has accounted for a third of all deaths. This study was conducted to assess maternal mortality ratio, demographic profile and causes of maternal death.Methods: This retrospective longitudinal study was conducted in the department of obstetrics and gynecology for a period of three years from 1st January 2018-31st December, 2020. Total no of death during this period was 134.Records of deaths and demographic profiles were retrieved from the medical record library of aforesaid hospital.Results: There were 134 maternal deaths amongst 56815 live births with MMR 235.85. The majority of deaths were in 20-29 year of age group and most of the deaths seen in multigravida. The 91.79% death was observed within the 24 hours and after 72 hours. Eclampsia, preeclampsia and hemorrhage were leading cause of maternal death seen in the study.Conclusions: Maternal mortality is higher than national MMR. Majority of maternal death were preventable by proper antenatal care, early detection of high-risk pregnancies and their timely referral to tertiary care centre.


Author(s):  
Shivraj More ◽  
Sujatha P. ◽  
Karthiga Karthiga

Background: Menopause is an inevitable milestone in the reproductive life of every woman. The objective is to investigate menopausal knowledge, attitude, symptoms and management among the participants, to identify the differences according to their educational status and to examine correlations of knowledge, attitude and symptoms pertaining to menopause.Methods: This cross-sectional study was conducted for a period of 10 months in postmenopausal women attending a tertiary care center in Pondicherry, India with a structured questionnaire developed on the basis of the objective of the study.Results: 330 postmenopausal women were recruited, and all were aware of their postmenopausal status. Mean age at menopause was 45.91±2.66 years. 54.5% were aware about what menopause was while 5.5% were unaware. 12.1% had proper knowledge about cause of menopause, whereas 3.6% said it is due to god’s decision / turning point. Most prevalent symptoms were tiredness (89.6%) followed by vasomotor symptoms like hot flushes (88.5%) and night sweats (80.3%). Only 2.1% had used HRT for menopausal symptoms.Conclusions: Depth of knowledge is more important when concern is about greater health disrupter which tends to be imperceptible for a long time such as bone health and cardiovascular risk profile. Thus, the government could concentrate on providing health services to women in post reproductive age group also besides women in the reproductive age.


2015 ◽  
Vol 8 (2) ◽  
pp. 86-91 ◽  
Author(s):  
Papa Dasari

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.


2019 ◽  
Vol 17 (31) ◽  
Author(s):  
Joseph Afolabi Ibikunle

Over half a million females die every year as a result of pregnancy and birth complications. The vast majority of these fatalities can be avoided. SDG 3.1’s objective is to reduce the global maternal mortality ratio by 2030 to below 70 per 100,000 live births. Despite a number of policies put in place maternal mortality in Africa remains unacceptably high. This study investigates the impact of maternal mortal- ity on sustainable development in 9 selected West African countries for the period from 1990 to 2015. Data used were adjusted net savings, maternal mortality, consumer price index, per-capita income and financial development. The second-generation econometric methods were employed: cross sectional dependence, slope homogeneity, Westerlund cointegration, Eberhadt and Teal AMG regression, and the Emirmahmutoglu and Kose bootstrap Granger causality test. Findings confirm the following: First, cross-sectional dependence and slope heterogeneity exist among the West African countries. Second, there is a long run relationship between maternal mortality and sustainable development. Third, maternal mortality impacted negatively and signifi- cantly on sustainable development. Fourth, the direction of causality varies across countries between maternal mor- tality and sustainable development. Lastly, causality runs from maternal mortality to sustainable development when analyzing the causal relationship among all countries. The findings suggest that the West African government needs to commit more funding to the health care sector and ensure access to free healthcare service to pregnant women or at low cost with quality and effective health care services if the countries must attain sustainable development by 2030.


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