The relationship between maternal death due to COVID-19 and the human development index in East Java, Indonesia.

Background: Maternal mortality rates and human development indexes can reflect a country's quality of health services. During the COVID-19 pandemic, these two achievement indicators are predicted to experience significant changes, and both have an interrelated relationship. Objectives: To find the relationship between maternal death due to COVID-19 and the Human Development Index (HDI) in East Java, Indonesia. Design and methods: A cross-sectional analytic study was carried out by processing secondary data from the provincial department of health regarding maternal mortality due to COVID-19 in East Java in 2020 and the HDI data from the Indonesian Central Statistics Agency. After that, the data were analyzed statistically using SPSS Statistics. Results: The number of maternal deaths due to East Java's COVID-19 during 2020 was 793 out of 1280. Furthermore, the HDI reached 2744.6, the first dimension contains life expectancy reaching 2725.3, and the number of health workers 100,021. In the second dimension, the literacy rate reaches 3482.9, and the average length of schooling is 134,341. Moreover, the last dimension contains a total population density of 40,878,789, and a poverty rate of 4572.7. Statistical analysis results show a positive relationship between maternal mortality due to COVID-19 and HDI, with a p-value of 0.008. Conclusion: There is a significant relationship between maternal mortality due to COVID-19 and HDI. However, the link between maternal mortality and COVID-19 related to the detailed dimensions contained in the HDI is not statistically related.

Successful management of a pregnant woman with COVID-19 and multiple severe complications.

We report a case of a 36-year-old gravida 2 para 1 woman at 38 weeks of gestation. A caesarean section was performed for severe pre-eclampsia, intrauterine growth restriction and oligohydramnios. The patient suffered postoperative bleeding, and exploratory laparotomy was performed. Uterine atonia, Couvelaire uterus and left adnexal haematoma were found, requiring a supracervical hysterectomy. As COVID-19 pneumonia and superimposed bacterial infection developed, the patient was mechanically ventilated in the intensive care unit. Remdesivir and meropenem were initially administered, but were changed to levofloxacin and ciprofloxacin following antibiotic sensitivity tests. Blood culture grew Enterococcus galinarum Meanwhile, bleeding of the incisional wound occurred, which was controlled by the cessation of heparin therapy and regular wound care. With intensive monitoring and multidisciplinary management, the patient's condition improved, and she was discharged from the hospital on day 25 from admission.