Background:Maternal mortality reflects the quality of obstetric services given to pregnant women in the community.Objectives:The objectives of this study were to calculate the maternal mortality rate in a teaching institution, to assess the epidemiological aspects of maternal mortality, and to assess the different causes of maternal mortality.Materials and Methods:This was a retrospective study where individual records of all maternal deaths occurring in our hospital during the past 6 years from 2009 to 2014 were studied. The cause of death and the factors which led to death in each individual case were analyzed.Results:A total of 105 maternal deaths occurred during the study period. The mean maternal mortality ratio in the study period was 233/100,000 live births. Most maternal deaths (37.14%) occurred in the age group of 20–24 years, multiparous women (74.28%) and in women from rural areas (70.47%). Most of the women were unbooked or unregistered patients (64.76%), and 40.95% cases were referred cases. Direct causes accounted for 90.47% of maternal deaths whereas 9.52% of maternal deaths were due to indirect causes. Hemorrhage (26.6%) and eclampsia (27.6%) were the major direct causes of maternal deaths.Conclusion:There is scope for improvement as a large proportion of the observed deaths are preventable. Improving the rural health centers, upgrading the referral centers, and proper transport system is the need of the hour.
Background: The anaesthetic technique to be used in Caesarean section is determined according to factors such as urgency, presence of coexisting health problems, preference of patient and preference and experience of the anaesthetist and surgeon.Methods: This is a retrospective study of all the caesarean deliveries that occurred in the period between 1st Jan 2010 to 31st Dec 2017 in the department of obstetrics and Gynaecology in Silchar Medical College. The anaesthesia techniques used for caesarean sections were evaluated in this study. Anaesthesia methods were recorded as general anaesthesia (GA) and regional anaesthesia (RA), and RA was classified into spinal anaesthesia (SA), epidural anaesthesia (EA) and combined spinal epidural anaesthesia (CSEA) subgroups.Results: During the study period a total of 75685 patients delivered and 25805 patients had undergone caesarean section. The caesarean section rate at the institution comes to be around 34.1%. Among the indications, it was observed that foetal distress (32.8%) was the commonest cause followed by post caesarean pregnancy (26.76%). The majority of the CS (75.6%) were done as an emergency procedure. Regional anaesthesia was the most frequently used method both in emergency (92.87%) and elective caesarean section (84.21%). SA was the commonest used RA (89.2%).Conclusions: In recent years, the rate of regional anaesthesia administration in caesarean section is gradually increasing, and the spinal anaesthesia technique is the mostly preferred regional anaesthesia. There is need to explore the use of the other forms of regional anaesthesia also.
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