5 years review of maternal mortality at FMH

To identify the main causes and associated factors contributing to maternal deaths. The medical record of all the women dying in the department of obstetrics and gynecology were reviewed. Demographic records including age, parity, socioeconomic status and antenatal care were analyzed from the patient's records. There were 16 maternal deaths during the study period with the maternal mortality ratio MMR of 52.04/100,000 live births[16/30,741]. The probable causes of deaths were ascertained on clinical assessment done jointly by gynaecologist, anesthetist and physician as postmortem examination was not done. The major causative factors were hemorrhage in 8[50%] patients, thromboembolism in 2[12.50%] septic shock in 2[12.50%] and acute pancreatitis in 1[6.25%].12/16 patients were unbooked and brought in emergency department. The ages of the women, who died ranged between 21-39 years. There were 5 primigravidas, 5 patients were Para 1-4, and 6 women had a parity more than 4. Most of the maternal deaths can be prevented by providing skilled obstetrical care at the time of delivery, by emergency department and proper management of complications. Safe motherhood requires no costly technology but only appropriate setting of resources; we also need public awareness, raising the self determination and awareness of women rights and improvement of her role in decision making

Morbidity associated with obesity in pregnancy

Obesity is associated with increased risk of illness and disability. It is one of the leading preventable causes of death in the World. Major maternal complications associated with obesity include diabetes mellitus, hypertension, deep vein thrombosis, respiratory diseases, infections and birth defects and even decreased fertility. Economic consequences of obesity are operative delivery and its complications, prolonged hospital stay. 1. To review maternal and fetal morbidity associated with obesity. 2. To observe the mode of delivery in obese pregnant female. Observational study [cross section]. This study was conducted at Khair-un-Nisa Hospital affiliated with Fatima Memorial Hospital from April 2011 to October 2011. 60 patients were enrolled in this study. Women with BMI more than 30 were included in our study. BMI was calculated by pre-pregnancy weight or weight during first trimester at booking within outpatient department. Patients with history of chronic hypertension, diabetes mellitus were not included in the study. The prevalence of obesity is increasing in our young population. In this study mean age is 30 years +/- SD 91.25. Most of the patients had BMI 33 +/- SD 2.80. Hypertension, diabetes, urinary tract infection 18.33%, congenital abnormalities 16.7%. Most of the patients ended on LSCS 30.5%, wound infection noted in 11 patients 18.3%. During normal vaginal delivery 4 patients 6.7% had third degree prenieal tear and 11 patients had post-partum hemorrhage. Fetal complications were birth asphyxia in 8 [13.3%] neonates and shoulder dystocia in 2 [3.3%] babies. Obesity is a public health problem because of its prevalence, cost and health effects. Maternal obesity carries significant risk for mother and fetus. Risk increases with degree of obesity. Feto-maternal morbidity associated with it, can be prevented by creating awareness and preventing overweight and obesity in adults and children