ABSTRACT
Background: Objective of this study was to calculate the maternal mortality rate in our hospital and to assess the epidemiological aspects and causes of maternal mortality to further analyse ways to reduce the maternal mortality rate (MMR).Methods: This was a retrospective analytical study done in the department of obstetrics and gynecology, MLN Medical College and District Women Hospital, Prayagraj over a time period of 10 years i.e., October 2009 to October 2019. Retrospective analysis and evaluation of the medical records and statistics was done to find out and collect specific causes of maternal deaths in the give time period.Results: There were 357 maternal deaths from October 2009 to October 2019. Maternal mortality rate in the study was calculated to be 498.42 per 1 lakh live births. Maximum deaths were in 21-30 years age group with multipara, unbooked and illiterate cases. Majority of the deaths reported were from direct causes of maternal mortality i.e., hemorrhage, hypertensive disorders and sepsis.Conclusions: In the selected hospitals, the mean maternal mortality rate in the study period was 498.42/100000 births. 71.4% had direct cause and 21.56% had indirect cause of maternal mortality several factors like regular antenatal visits, early identification of high-risk cases, timely referral, institutional deliveries, adequate post-partum care and follow-up can contribute to decrease the maternal mortality rate effectively.
ABSTRACT
PURPOSE: This study was conducted to analyze recent trends and causes of maternal mortality in Korea between 2009 and 2014. METHODS: We investigated trends and causes of maternal death using the data from Complementary Investigations on the Infant, Maternal, and Perinatal Mortality carried out by Statistics Korea between 2009 and 2014. Maternal age, administrative district, causes of death and gestational age at the time of death were collected from data. Statistics including maternal mortality ratio (MMR) and maternal mortality rate were calculated. We also analyzed MMR according to the age, and administrative districts. The causes of maternal death were sorted and classified using International Classification of Diseases and World Health Organization recommendations. RESULTS: The average MMR during 6 years was 13.16 and maternal mortality rate was 0.45. MMR was highest in 2011 (17.2) and lowest in 2012 (9.9). The average MMR of the administrative districts varied greatly from 7.51 (Gwangju) to 26.84 (Jeju). The average MMR during the study period was lowest in maternal age of 20-24 (6.9), and highest in 45-49 (143.7). On average, direct and indirect maternal deaths accounted for 66.2% and 29.9% of total maternal death, respectively. The three most common causes of maternal deaths were obstetrical embolism (24.4%), postpartum hemorrhage (18.3%), and hypertensive disease of pregnancy (5.5%) in decreasing order of frequency. CONCLUSION: Although MMR is decreasing during the study period, it fluctuates widely according to maternal age, districts, and constant effort for improvements is necessary. To reduce maternal deaths, solution to control preventable causes of maternal deaths, careful management of pregnancies with advanced maternal age, and policy to solve the discrepancy in the medical services among diverse regions in the country are needed.
Subject(s)
Humans , Infant , Pregnancy , Cause of Death , Embolism , Gestational Age , International Classification of Diseases , Korea , Maternal Age , Maternal Death , Maternal Mortality , Perinatal Mortality , Postpartum Hemorrhage , World Health OrganizationABSTRACT
Background: Objectives: To compare misoprostol 600 mcg, oral with carboprost 125 mcg, i.m., in the active management of third stage of labour. Methods: A total of 200 pregnant women of 38-42 weeks of gestation delivering vaginally in the Shivamogga institute of medical sciences, Shivamogga, Karnataka, India were selected for study. 100 women received misoprostol 600 mcg, orally and 100 women received carboprost 125 mcg, i.m. immediately after delivery of baby and cord clamping by the method of randomisation. Results: In the misoprostol group, mean blood loss is 134.9 ml, mean duration of the third stage of labour is 4.07 min and mean fall in hemoglobin is 0.34 g/dl. In the carboprost group, mean blood loss is 123.7 ml, mean duration of the third stage of labour is 3.73 min and mean fall in hemoglobin is 0.28 g/dl. There was no significant difference between the two groups with regard to the above mentioned factors. There were 5 cases of PPH in the misoprostol group and 3 cases in the carboprost group. 21 cases in the misoprostol group and 14 cases in the carboprost group required additional oxytocics. Unpleasant side effects like diarrhoea and vomiting were more in carboprost group. Conclusion: Oral misoprostol is as effective as carboprost in AMTSL and can be used safely in vaginal deliveries for prevention of PPH, especially in non-institutional deliveries and in places of low resource settings.
ABSTRACT
Objective To provide evidence for further reducing the maternal mortality rate (MMR) through analyzing the causes of death and influencing factors on the issue.Methods Every maternal death from 1996 to 2010 was audited by experts and relevant information was collected and analyzed,retrospectively.Results (1) The overall MMR among Beijing residents was 20.2 per 100 000 live births in 1996-2000 while decreased to 14.2 per 100 000 live births from 2006 to 2010.At the same time,the MMR of migrating people decreased from 47.7 to 15.2 per 100 000 live births.(2) The proportion of women having received middle school education and above,increased from 59.8％ to 78.8％ and the non-prenatal care maternal ratio decreased from 39.1％ to 12.7％.(3) Among the 349 deaths in the period of 1996-2010,209 (59.9％) were caused by direct obstetric reasons.Proportion of obstetric hemorrhage declined from 14.4％ to 9.2％ and the amniotic fluid embolism declined from 20.7％ to 15.0％.Prolific,non-prenatal care and private clinics/home deliveries were important factors on direct obstetric reasons.71.4％ maternal mortality of indirect causes appeared abnormal during pregnancy.(4) The WHO twelve-grade classification standard on maternal deaths was adopted.Our data showed that the main reasons causing maternal deaths of Beijing residents were related to the skills of medical staffs (62.4％) and healthcare management (19.7％).The main reasons of maternal deaths among migrating people would include:poor knowledge (41.4％),inappropriate attitude(32.3％) and resources of the families(24.0％).Conclusion The MMR in Beijing continuously declined from 1996 to 2010.However,in order to keep up with the changing causes related to maternal deaths as well as to the increasing service requirements,it is necessary to develop a new model on service and management of the issue.
ABSTRACT
To study the maternal mortality and common complication leading to maternal death over a period of 10yrs from Jan 1999 to Dec. 2009.A retrospective study of hospital records and death summaries of all maternal deaths over 10 yr periods was carried out. MMR of 270.33/1,00,000 live births was observed over a period of 10 yrs. post partum hemorrhage was the leading direct cause and anemia the leading indirect cause. Most women died within 24 hrs of admission. The age group of 20-30 yrs was crucial. Most deaths were in unbooked cases transferred from outside. Hemorrhage and PIH are major causes of death. Most maternal deaths are one preventable by quality health education of women & adequate care to the mothers at all levels district health system.
ABSTRACT
The study was conducted to determine the maternal mortality rate (MMR), various factors affecting it and possible prevention of maternal deaths in Christian Medical College & Hospital, a tertiary care institute during the past five years (2001- 2005). The individual record of maternal deaths was studied regarding their socio-demographic features, causes, modes of management and ultimate outcome. The Maternal Mortality rate was 1470 per lac live births. The major obstetrical complications accounted for more than three fourth of maternal deaths with hemorrhage (33%), sepsis (21.7%) and eclampsia (7.5%) playing an important role. Anemia (44.3%) and jaundice (16.0%) were two important indirect causes of maternal deaths. Un-booked cases accounted for majority of maternal deaths. Only two maternal mortality patients were showing regularly in our institute, rest all of the patients either had no antenatal check-up or were having ANC in private clinics and were referred as an emergency in critical condition. More than 90% of maternal deaths hailed from rural and urban slum areas. 61 (57.8%) cases received primary care from untrained birth attendants and 11 (10.4%) did not receive primary care in any form. There was delayed referral by the untrained personnel, 49 (46.2%) patients were referred after more than 48 hours of acute emergency, 51 (48.1%) died between 24 to 48 hours and 25 (23.6%) died within 24 hours of admission in spite of all resuscitative measures. It is concluded that providing good antenatal care, finding appropriate ways of preventing and dealing with the consequences of unwanted pregnancies, and improving the way society looks after pregnant women are three most important ways to reduce maternal mortality.
ABSTRACT
Chile adquirió el compromiso internacional de reducir la tasa de mortalidad materna en un 50% en el período 1990-2000. Entre 1990 y 1999, los nacimientos (-14,2%), las muertes maternas (-51,2%) y la tasa de mortalidad materna (-43,1%) disminuyeron significativamente. Mientras que entre los años 1998 y 1999, los nacimientos disminuyeron (-2,5%), pero aumentaron las muertes maternas (+ 9,1%) y la tasa de mortalidad materna (+ 11,8%), probablemente por un aumento del alto riesgo obstétrico, debido al desplazamiento de los nacimientos a edades maternas mayores. Las tendencias demográficas dificultan el cumplimiento de la reducción comprometida.
Chile acquiered an international compromise to reduce the maternal mortality rate to 50% in the period 1990-2000. In 1990-1999, births (-14.2%), maternal deaths (-51.2%) and maternal mortality rate (-43.1%) decreased. While in 1998-1999, births decreased (-2.5%), but the maternal deaths (+9.1%) and the maternal mortality rate (+11.8%) increased, probably for a higher obstetrics risk population, because births displacement to a higher maternal age. Demographic trends make difficult to perform the fulfillment reduction.
ABSTRACT
Objective To establish the healthcare management mode for pregnant women adapting to the characteristics of transient population which can safeguard the maternal and infant health or reduce the maternal mortality rate and prenatal mortality rate. Methods Five suburban communities of Chaoyang District, Haidian District and Fengtai District of Beijing were chosen as intervention group, which received systemic healthcare management of pregnant women in transient population, another five suburban communities were selected as control group. Results Both maternal mortality rate and prenatal mortality rate in intervention group were lower than those in control group. To evaluate the effect of systemic healthcare for pregnant women, an average of four antenatal clinic visits were completed in intervention group and eight visits in control group. There was no statistical difference in occurrence of maternal complications, newborn weight and occurrence rate of neonatal asphyxia between two groups. The expense of hospital vaginal delivery was no more than 1000 yuan in intervention group and more than 1000 yuan in control group, while the outcomes of mothers and neonates in two groups had no significant difference. Conclusion The systemic healthcare and community management mode for pregnant women in transient population can safeguard the maternal and infant health with scientific, practical, and replica-ble significances.