Study of septic abortion cases at a tertiary centre of Uttarakhand.

Aim of this study was to evaluate the incidence, maternal morbidity & mortality, clinical features, management in cases of septic abortion in a tertiary centre. This study included 37 cases of septic abortion admitted during 5 years from January 2007 to January 2012 in the Department of obstetrics & Gynaecology in Government Medical College, Haldwani. All patients were evaluated with special reference to incidence, etiological factors, clinical features, surgery & maternal morbidity & mortality. The incidence of septic abortion was 1.08%. Common age group was between 26-30 years. Most of the cases were from lower socioeconomic status. Septic abortion following spontaneous abortion was present in 5 cases. Unwanted pregnancy was the indication for termination of pregnancy in 32 cases. 4 women were admitted in state of septic shock. 12 cases required lapratomy for drainage of pus, 3 had hysterectomy, 3 had resection anastomosis & uterus repair was done in 4 cases. Overall maternal mortality was 5 (13.5%).The incidence of illegal and septic abortion can be reduced by increasing awareness about family planning services and making legal abortion services easily available to the women and that too at a cheaper cost.

Maternal mortality in a tertiary care teaching hospital

Every women can experience sudden and unexpected complications during pregnancy, child birth and just after delivery. Although high quality accessible health care has made maternal death a rare event in developed countries, these complications can often be fatal in the developing world. Safe motherhood as a priority for action can not be identified without properly assessing maternal mortality. The aims of this study were toanalyse the causes of maternal mortality and thus determine the preventable factors responsible for maternal deaths. Descriptive study. This study was carried out at DHQ Hospital Faisalabad from June 2002 to December 2004. Patients were admitted through emergency and Obstetrics and Gynaecology out-patient department. Patient age, parity, education, socio-economic status, antenatal booking level of care, whether come from rural or urban area, and distance from hospital were noted. Contributing and causative factors leading to maternal mortality were evaluated. All these information were recorded on a specially design Performa. Results: Total number of maternal deaths recorded during 2 V[2] years study period were 70. The causative factors of maternal mortality were sepsis 19[27%], post partum hemorrhage 18 [25.7%], eclan‡sia 11[15.7%], pulmonary embolism 7[10%], liver disease 6[8.5%] heart disease 5[7.1%], anaesthetic complications [3][4.2%] and one death [1.4%] due to miss match] blood transfusion in a private hospital. Patient's age ranged between 18-45 years. 40[57.1%] patients were <31 years old. 15[21.4%] patients were prmigravida or Para one and 55 [78.5%] were multigravida or multi para. All patients were unbooked, uneducated and belonged to poor socio-economic setup. Majority of them came from distance between 20-60 km. 40[57.1%] were attended by traditional birth attendant, 18 [25.7%] by lady health visitors, [3][4.2%] by doctors in private clinics and 9[12.8%] received no level of care. Sepsis, obstetrical hemorrhage, eclampsia and pulmonary embolism are major causative factors of maternal mortality

Anemia and maternal mortality in the developing world

This article analyzes current knowledge of the effects of anemia and iron deficiency on maternal mortality. Current knowledge indicates that iron deficiency anemia in pregnancy is a major risk factor, and might contribute to maternal mortality in the developing world. The purpose of this article was to examine published information regarding the prevalence of anemia in the developing world, analyze its obvious causes that are well documented, as well as those that are less obvious and less well documented and its effects on pregnancy outcome and to identify current gaps in the information. Furthermore, its purpose was to paintt a comprehensive and realistic picture of the present situation, and an attempt was made to propose a solution, or to at least urge researchers and concerned government personnel to take the much needed action and further exploration that the subject demands. This could be done by not neglecting the problem any further. The reviewers conclude that the weight of evidence supports the advisability of changing our priorities towards primary health care, developing a more objective research methodology, and employment of universal food fortification programs on a large scale

Mortalidad materna: centro materno infantil San Lorenzo de los Mina, 1984-1988

Se realizó un estudio retrospectivo en el Centro Materno Infantil San Lorenzo de Los Mina en el período comprendido entre el 1ro. de enero de 1984 al 31 diciembre de 1988, con el objetivo de conocer el comportamiento de la mortalidad materna. Encontramos 69 defunciones entre las cuales la eclampsia ocupó el 1er. lugar como causa con 45%. La tasa de mortalidad materna en el Centro Materno Infantil San Lorenzo de Los Mina oscilo entre 1.0 y 1.5 defunciones por cada 1,000 nacidos vivos

Mortalidade materna na Maternidade Mário Totta: um estudo de 10 anos / Maternal mortality at the Mário Totta Maternity: a 10-year study

Em um período de 10 anos (1979-1988), ocorreram 68 óbitos maternos na Maternidade Mário Totta. O número de recém-nascidos vivos no mesmo período foi de 52140, resultando num coeficiente de mortalidade materna de 130,4/100000 recém-nascidos vivos. As causas obstétricas diretas foram responsáveis por 70,6% dos óbitos; as obstétricas indiretas por 11,8% e as näo obstétricas por 14,7%. Em dois casos näo foi identificada a causa mortis. A infecçäo foi a principal causa de morte, estando envolvida em 47,1% dos casos, sendo seguida por hemorragia (em 23,5%) e complicaçöes hipertensivas (em 16,1%). Outras causas tiveram pequena participaçäo. A necropsia foi realizada em 13(19,1%) pacientes. Cesariana, idade mais avançada e multiparidade foram importantes fatores de risco

Mortalidade materna na Maternidade do Hospital de Clínicas da UFPr - Curitiba (1981-1985) / Maternal mortality in Maternidade do Hospital de Clínicas da UFPr - Curitiba (1981-1985)

Entre janeiro de 1981 e janeiro de 1986 registraram-se 37 óbitos maternos na Maternidade do Hospital de Clínicas da Universidade Federal do Paraná, correspondendo a um coeficiente de mortalidade materna (MM) de 43,11 por 10000 nascidos vivos. O estudo restringiu-se a pacientes entre 12 e 48 anos completos e procura analisar as principais caiusas de decesso materno no Serviço. O óbito foi mais freqüente entre 21 e 30 anos de idade (59,46%) e entre multíparas (62,16%). A maioria das pacientes (70,27%) näo teve acompanhamento pré-natal e um percentual significativo (62,17%) encontrava-se no puerpério tardio. Como principais patologias determinantes do óbito foram encontradas: causas infecciosas (40,54%), acidente vascular cerebral hemorrágico (24,32%) e choque hipovolêmico (13,51%). Conclui=se que a gestaçäo, embora situaçäo fisiológica, merece atençäo médica especial por estar sujeita a riscos inerentes a esta condiçäo

Perspectivas de la salud materna y neonatal en Portugal / Perspectives of maternal and perineatal health in Portugal

En este trabajo se identifican las causas remotas y recientes de morbilidad y mortalidad materna e infantil y se hace un análisis de los principales problemas de esta área de la salud en Portugal. En seguida se presentan algunas alternativas para la solución de las dificultades y se concl uye que con los recursos disponibles es posible mejorar en forma sustancial los cuidados maternos y neonatales

Embolia de líquido amniótico: análisis de 22 pacientes / Embolism of amniotic fluid: analysis of 22 patients

Se hace un análisis de 22 mujeres maternas con diagnóstico anatomopatológico de embolia de líquido amniótico y una revisión de la literatura al respecto. La frecuencia fue de 1 por 32.506 partos y 1 por 32.620 recién nacidos. El 63,9% tuvieron una edad de 31 años o más. Hubo una mayoría de multigestas, el 72,2% fueron embarazos prolongados, hubo una gran frecuencia de desprendimiento prematuro de placenta y de óbito fetal. El líquido meconial estuvo presente en el 30,7% de las pacientes. Los síntomas y signos clínicos prevalentes fueron: la dificultad respiratoria y el shock hipovolémico. La cesárea se realizó en el 31,8%. Hubo 3 roturas uterinas. El peso promedio de los recién nacidos fue de 3.256 grs. De las muertes maternas por causas obstétricas, la mortalidad por embolia de líquido amniótico explicó el 2,4%

Mortalidade materna hospitalar nas unidades mistas da fundaçäo SESP 1979-1981 / Hospitalar maternal mortality in mixed units of the Fundaçäo SESP 1979-1981

Os dados em análise referem-se aos óbitos maternos ocorridos em trinta e sete Unidades Mistas da Fundaçäo SESP, em funcionamento no período de 1979 a 1981. Determinou-se a taxa média de mortalidade materna hospitalar para o conjunto das Unidades, para cada Diretoria Regional e, ainda, por faixa etária. As causas de óbito foram classificadas segundo a Classificaçäo Internacional de Doenças, até três dígitos, destacando-se as causas obstétricas diretas que foram distribuídas em seis subgrupos, surgindo como mais importantes as hemorragias, as toxemias e as infecçöes