scholarly journals Review Article on Emergency Obstetric Care

2018 ◽  
Vol 1 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Silas Ochejele
Keyword(s):  
Maternal Mortality ◽  
Low Income ◽  
Newborn Care ◽  
Emergency Obstetric Care ◽  
Skilled Birth Attendant ◽  
Obstetric Care ◽  
Functional Health ◽  
Low Income Countries ◽  
Mortality Reduction ◽  
Maternal Deaths

Maternal death was once a common occurrence worldwide but today, 99% of maternal deaths occur in low income countries. Most of the maternal deaths are due to direct obstetric complications. Emergency obstetric care is the intervention required to save the lives of these women. It is based on a tripod of signal functions, skilled birth attendants and a functional health system. The objective of this article was to discuss the role of Emergency obstetric care in maternal mortality reduction. A systematic review of available articles on Emergency obstetric care; and Emergency obstetric care training materials, experience and observations used/made between 2003 and 2017 in Nigeria was used for this work. Emergency obstetric care is the nucleus on which all other maternal mortality reduction activities are hinged. The paradigm evolvement of Emergency obstetric care offers the last hope for a woman with direct obstetric complication. However, the skilled birth attendant must have the right attitude in addition to her/his professional skills for effective implementation of these interventions. Women need access to and availability of Emergency obstetric care as well as a continuum of care that includes antenatal, intra-partum and postnatal care, newborn care and family planning services to reduce maternal mortality.

scholarly journals MATERNAL MORTALITY

2009 ◽  
Vol 16 (01) ◽  
pp. 135-138
Author(s):  
TASNIM TAHIRA REHMAN ◽  
MAHNAZ ROOHI
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Level ◽  
Maternal Deaths ◽  
Mortality Ratio ◽  
Study Setting ◽  
Very High

Objective: To find out maternal mortality ratio (MMR) and to determine major causes of maternal death. S t u d y d e s i g n:A descriptive study. Setting: Department of Obstetric and Gynaecology, Allied Hospital, Faisalabad. S t u d y period: From 01.01.2008 to31.12.2008. Materials a n d m e t h o d s : All cases of maternal death during this study periods were included except accidental deaths. Results:There were 58 maternal deaths during this period. Total No. of live births were 5975. MMR was 58/5975 x 100,000 = 970/100,000 live births.The most common cause of maternal death was hemorrhage (34.5%) followed by hypertensive disorders/eclampsia (31%). Most of thepatients (75.86%) were referred from primary & secondary care level. C o n c l u s i o n : Maternal mortality is still very high in underdevelopedcountries including Pakistan. We must enhance emergency obstetric care (EOC) to achieve the goal of reduction in MMR.

scholarly journals Maternal mortality and its relationship to emergency obstetric care (EmOC) in a tertiary care hospital in South India

2015 ◽  
Vol 8 (2) ◽  
pp. 86-91 ◽  
Author(s):  
Papa Dasari
Keyword(s):  
Maternal Mortality ◽  
Cause Of Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Emergency Admissions ◽  
Mortality Ratio

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.

scholarly journals Maternal deaths in developing countries: A preventable tragedy

2009 ◽  
Vol 15 (2) ◽  
Author(s):  
Gunnar Kvåle ◽  
Bjørg Evjen Olsen ◽  
Sven Gudmund Hinderaker ◽  
Magnar Ulstein ◽  
Per Bergsjø
Keyword(s):  
Public Health ◽  
Health Care ◽  
Maternal Mortality ◽  
Low Income ◽  
Health Care Systems ◽  
Health Problems ◽  
Low Income Countries ◽  
Public Health Importance ◽  
Maternal Deaths ◽  
Care Systems

The neglected tragedy of persistent high maternal mortality in the low-income countries is described. One of the millennium development goals states that the current number of maternal deaths of around 500,000 per year should be reduced by three quarters by 2015. Since the major causes and avenues for prevention are known, this may seem an achievable goal. It is concluded, however, that unless all stakeholders globally and within individual countries will demonstrate a real commitment to translate policy statements into actions, it is unlikely that the goal will be reached. A substantial increase in the resources for reproductive health care services is needed, and the human resource crises in the health care systems must be urgently addressed. Epidemiologists have an important role to play by designing randomized controlled trials for estimating the effect of different health care systems interventions aimed at reducing maternal mortality and other major health problems in low resource settings. The public health importance of such trials may be greater than the potential benefit of randomized trials for investigating effects of new vaccines and drugs. Within the field of perinatal epidemiology the disparity in public health importance of research conducted in the rich versus the poor world is glaring. Time is overdue for perinatal epidemiologists to turn their attention to the areas of the world where the maternal and perinatal health problems are overwhelming.

scholarly journals Retrospective analysis of maternal mortality: a paradigm shift from 2010 to 2020

2021 ◽  
Vol 10 (8) ◽  
pp. 3079
Author(s):  
Sujani Kempaiah ◽  
Urvashi . ◽  
Mamatha . ◽  
Jessica Celina Fernandes ◽  
Gayatri Devi Sivasambu ◽  
...  
Keyword(s):  
Health Services ◽  
Maternal Mortality ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Well Being ◽  
Hospital Data ◽  
College Hospital ◽  
Maternal Deaths ◽  
Diagnosis And Management ◽  
Hypertensive Disorders

Background: Maternal mortality is attributed usually to complications that generally occur during or around labour and these are mostly preventable through proper understanding, diagnosis and management of labour complications. The quality of health services women receive during pregnancy, intranatal and postnatal periods are crucial for the survival and well-being of the mother and her newborn baby. The objective was to analyse the changing trends in maternal mortality occurring over a decade, to assess factors associated with maternal mortality and propose effective interventions in preventing such mortality.Methods: It was a retrospective study to analyse maternal mortality between January 2010 and January 2020 in Ramaiah medical college hospital. Data was collected the institutional medical and delivery records and patient details regarding obstetric history, pre-existing comorbidities, cause of death, interventions done was noted and review of maternal mortality was done.Results: The maternal mortality in the present study was 432.73/1 lakh live births. There were 57 maternal deaths in the study period. Most deaths occurred in the 20-25 age group. 42.10% of deaths occurred ninety six hours after admission. Sepsis (42.1%), hypertensive disorders (12.30%) and haemorrhage (10.5%) are the most common direct causes of maternal death. Post-operative and post abortal sepsis, ARDS, cardiogenic shock, pulmonary embolism and AFLP are the other direct causes. Hypertensive disorders (9.64%) and haemorrhage (19.5) is the two leading indirect causes of maternal deaths.Conclusions: Maternal health services should move beyond the focus on emergency obstetric care, to a broader approach that encompasses preventive and early interventions and integration with existing services. Most of the maternal deaths can be prevented if the high risk antenatal women are identified earlier and referred to the tertiary centre earlier for diagnosis and management. 

scholarly journals Facteurs Associes Aux Deces Maternels A L’hôpital De Zone Saint Jean De Dieu De Tanguieta De 2015 A 2019

2021 ◽  
Vol 17 (29) ◽  
pp. 93
Author(s):  
Atade Sèdjro Raoul ◽  
Hounkponou Ahouingnan Fanny Maryline Nouessèwa ◽  
Obossou Achille Awadé Afoukou ◽  
Gabkika Bray Madoué ◽  
Doha Sèna Mireille Isabelle ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Low Income ◽  
Maternal Mortality Ratio ◽  
Public Health Problem ◽  
Low Income Countries ◽  
Maternal Deaths ◽  
Live Births ◽  
Factors Associated ◽  
Mortality Ratio ◽  
Faible Revenu

Introduction: La mortalité maternelle est un problème de santé publique au Bénin ; Elle est estimée à 397 pour 100 000 Naissances Vivantes (NV) en 2017. Dans les pays à faible revenu le ratio de mortalité maternelle est de 239 pour 100 000 Naissances Vivantes (NV). Objectifs: Identifier les facteurs associés aux décès maternels à l’Hôpital de Zone Saint Jean de Dieu de Tanguiéta de 2015 à 2019. Méthode d’étude: Il s’est agi d’une étude rétrospective à visée descriptive et analytique. Les dossiers des femmes ont été dépouillés pour collecter les informations relatives aux variables de l’étude. Résultat: Durant la période d’étude, nous avons recensé 222 dossiers. Le ratio de mortalité maternelle intra-hospitalière était de 1173 décès pour 100 000 naissances. L’âge moyen des femmes décédées était de 25,4 ans. Les femmes décédées étaient des ménagères dans 72,1%. Plus de la moitié des femmes décédées (55,9%) n’avaient bénéficié d’aucune consultation prénatale. La référence était le principal mode d’entrée à l’hôpital (64%). Les causes obstétricales directes des décès étaient dominées par les hémorragies (25,8%), les troubles hypertensifs (22,8%) et les infections puerpérales (21,2%). Les facteurs associés aux décès maternels étaient : le milieu de résidence (p = 0,004), le délai (de 5jours et plus) entre l’apparition des symptômes et l’admission à l’hôpital (p = 0,019), le transport non médicalisé (p=0,013) et le troisième retard (p < 0,001). Conclusion: Le ratio de mortalité maternelle était élevé à l’hôpital de zone Saint Jean de Dieu de Tanguieta. Il importe que des actions soient menées en agissant sur les différents facteurs en vue de réduire la mortalité maternelle dans cet hôpital. Introduction: Maternal mortality is a public health problem in Benin, it is estimated at 397 per 100,000 Live Births (LB) in 2017. In low-income countries the maternal mortality ratio is 239 per 100,000 Live Births (LB). Objectives: Identify the factors associated with maternal deaths at the Saint Jean de Dieu Zone Hospital in Tanguiéta from 2015 to 2019. Study Method: This was a retrospective study with a descriptive and analytical aim. Women's records were searched to collect information on study variables. Result: During the study period, we identified 222 cases. The intrahospital maternal mortality ratio was 1,173 deaths per 100,000 births. The average age of the deceased women was 25.4 years. 72.1% of the deceased women were housewives. More than half of the women who died (55.9%) had not received any prenatal consultation. Referral was the main mode of entry to hospital (64%). The direct obstetric causes of death were dominated by haemorrhages (25.8%), hypertensive disorders (22.8%) and puerperal infections (21.2%). Factors associated with maternal deaths were: place of residence (p = 0.004), the time (5 days or more) between the onset of symptoms and admission to hospital (p = 0.019), unsafe transportation (p = 0.013) and The third delay (p <0.001). Conclusion: The maternal mortality ratio was high at the Saint Jean de Dieu hospital in Tanguieta. It is important that actions be taken by acting on the various factors in order to reduce maternal mortality in this hospital.

scholarly journals Reducing Maternal Mortality: an Assessment of the Availability and Quality of Emergency Obstetric and Newborn Care in Esan Central Local Government Area of Edo State

2019 ◽  
Author(s):  
Sunday Emmanuel JOMBO ◽  
Ehigha ENABUDOSO ◽  
Anthonia NJOKU ◽  
Jedidiah AFEKHOBE
Keyword(s):  
Health Care ◽  
Maternal Mortality ◽  
Health Care Providers ◽  
Maternal Death ◽  
Newborn Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Providers ◽  
Referral Network

Abstract BackgroundThere is global public health burden of maternal mortality and is worse in Sub-Saharan Africa. Esan Central LGA in Nigeria has an estimated maternal mortality of 1747 per 100,000 live births which is unacceptably high. Emergency obstetric care has been advocated as a measure to avert maternal mortality as about 15% of pregnancies developed complications which may be unpredictable. There is therefore need to access the availability and quality of EmOC in the area. This study aimed to assess the availability and quality of emergency obstetric and newborn care (EmONC) services in the areaMethodsWe conducted a descriptive cross-sectional study and an in-depth interview. Data was collected using UN/AMDD assessment tools (Handbook). Forty key informants’ interviews with major facility managers, pregnant women and health care providers were also done and triangulated. Analysis was done using IBM SPSS statistics- 20, while the in-depth interviews were audio taped, transcribed and analyzed by thematic coding. In addition EmONC services indicators were calculated.ResultThe availability of EmONC services in Esan central LGA was 3.7/500,000 population. The availability of EmONC services was limited at the primary and secondary level of health care. The comprehensive EmOC was adequate (3.7/500000 population) and it is available at the tertiary health facility. The met need for EmONC was 62.6%, obstetric case fatality was 1.2%, and caesarean section rate was 24 %, while the still birth rate was 2.6%. The respondents had adequate knowledge and concern about the burden of maternal death. Major causes of maternal death reported were haemorrhage, hypertension / convulsion in pregnancy and prolong labour. Major contributing factors to maternal death are lack of money, poor antenatal care, and poor attitudes of health care providers, inappropriate referral network, lack of equipment and EmONC drugs, inadequate skill birth attendants and delay in getting treatment. Overall remark on the quality of EmONC services was poor.Conclusion There are limited EmONC services at the primary and secondary health centers that require urgent attention in effort to reducing maternal mortality. There is need for supply of equipment, emergency obstetric care drugs, training and re-training of staff. The community and the health care providers need re-orientation as to the reproductive health care requirements of the people in such a manner that is client centered and with appropriate referral network.

scholarly journals Impacts of discriminated PM2.5 on global under-five and maternal mortality

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Patrick Opiyo Owili ◽  
Tang-Huang Lin ◽  
Miriam Adoyo Muga ◽  
Wei-Hung Lien
Keyword(s):  
Maternal Mortality ◽  
Low Income ◽  
Intervention Strategy ◽  
Positive Association ◽  
Global Scale ◽  
Low Income Countries ◽  
Maternal Deaths ◽  
Under Five ◽  
Life Years ◽  
Increased Risk

Abstract Globally, it was estimated that maternal and under-five deaths were high in low-income countries than that of high-income countries. Most studies, however, have focused only on the clinical causes of maternal and under-five deaths, and yet there could be other factors such as ambient particulate matter (PM). The current global estimates indicate that exposure to ambient PM2.5 (with ≤ 2.5 microns aerodynamic diameter) has caused about 7 million deaths and over 100 million disability-adjusted life-years. There are also several health risks that have been linked PM2.5, including mortality, both regionally and globally; however, PM2.5 is a mixture of many compounds from various sources. Globally, there is little evidence of the health effects of various types of PM2.5, which may uniquely contribute to the global burden of disease. Currently, only two studies had estimated the effects of discriminated ambient PM2.5, that is, anthropogenic, biomass and dust, on under-five and maternal mortality using satellite measurements, and this study found a positive association in Africa and Asia. However, the study area was conducted in only one region and may not reflect the spatial variations throughout the world. Therefore, in this study, we discriminated different ambient PM2.5 and estimated the effects on a global scale. Using the generalized linear mixed-effects model (GLMM) with a random-effects model, we found that biomass PM2.5 was associated with an 8.9% (95% confidence interval [CI] 4.1–13.9%) increased risk of under-five deaths, while dust PM2.5 was marginally associated with 9.5% of under-five deaths. Nevertheless, our study found no association between PM2.5 type and global maternal deaths. This result may be because the majority of maternal deaths could be associated with preventable deaths that would require clinical interventions. Identification of the mortality-related types of ambient PM2.5 can enable the development of a focused intervention strategy of placing appropriate preventive measures for reducing the generation of source-specific PM2.5 and subsequently diminishing PM2.5-related mortality.

scholarly journals Audit of Maternal Deaths in the Context of the Free Obstetrical Care at the Maternity of the Ignace Deen National Hospital of Conakry Chu

2021 ◽  
Vol 6 (1) ◽  
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Low Income ◽  
Obstetric Care ◽  
Blood Products ◽  
National Hospital ◽  
Maternal Deaths ◽  
Major Health Problem ◽  
Live Births ◽  
Technical Platform

Objectives: To describe the evolution of half-yearly maternal mortality ratios, to describe the socio-demographic characteristics of the patients who died in the facility, to analyse the causes and determining factors of maternal deaths that have occurred in the facility, and to implement strategies to reduce this maternal mortality. Methodology: this was a descriptive, cross-sectional and analytical study carried out at the maternity ward of the Ignace Deen National Hospital of the Conakry University Hospital with data collection in two phases, including a retrospective lasting 6 months from July 1 to December 31, 2018, and the other prospective for a period of 18 months from January 1, 2019, to June 30, 2020. Result: During the study period, 224 deaths were recorded out of a total of 8,539 live births, for an intra-hospital maternal mortality ratio of 2,623.25 per 100,000 live births. The profile of women at risk of maternal death was as follows: patients aged 20-31 (56.26%), married (87.6%), low-income (41.96%), multiparous (33, 1%), evacuated from a peripheral maternity hospital (79.91%), multi guest (34.9%). The majority of deaths occurred within the first 24 hours (75%). The majority of deaths were due to direct obstetric causes: postpartum haemorrhage (52.68%), eclampsia (21.88%). Indirect obstetric causes were dominated by anaemia (16.07%). But in some cases, two or even three factors were associated with the occurrence of the same maternal death. The most frequently encountered obstetric period of death was postpartum (77.68%). The average recovery time was 31.96 minutes. The lack of blood products and the inadequacy of the technical platform were the main associated factors. Also, it appears that all our cases of death were preventable. The causes of the dysfunctions were attributable: to the person by their attitude (delay in specific care); in the hospital for the lack of equipment and blood products and in the consultation. Free obstetric care was not complete in some cases. Conclusion: maternal mortality is a major health problem in our structure. Its reduction requires the mobilization of all actors in society involving good health education; improving the quality of prenatal consultations and emergency obstetric care by consciously taking charge of staff and strengthening the technical platform.

scholarly journals Maternal Mortality from Induced Abortion in Malawi: What Does the Latest Evidence Suggest?

2021 ◽  
Vol 18 (19) ◽  
pp. 10506
Author(s):  
Calum Miller
Keyword(s):  
Maternal Mortality ◽  
Spontaneous Abortion ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Induced Abortion ◽  
Substantial Proportion ◽  
Unsafe Abortion ◽  
Maternal Deaths

It is commonly claimed that thousands of women die every year from unsafe abortion in Malawi. This commentary critically assesses those claims, demonstrating that these estimates are not supported by the evidence. On the contrary, the latest evidence—itself from 15 to 20 years ago—suggests that 6–7% of maternal deaths in Malawi are attributable to induced and spontaneous abortion combined, totalling approximately 70–150 deaths per year. I then offer some evidence suggesting that a substantial proportion of these are attributable to spontaneous abortion. To reduce maternal mortality by large margins, emergency obstetric care should be prioritised, which will also save women from complications of induced and spontaneous abortion.

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