Burden and causes of maternal mortality and near-miss in a tertiary care centre of Kerala, India

Umadevi, Sreekumari; Ayesha, Simi; Radha, Sreekumari; Nair, Anish Thekkumkara Surendran; Sulochana, Krishna Devadhas

doi:10.18203/2320-1770.ijrcog20170462

Cited by 3 publications

(7 citation statements)

References 12 publications

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“…This indicates our MNM ratio is at par than other Indian studies conducted from year 2017 to 2020. While addressing MNM-Mortality ratio results of this study are significantly different than a study [8]. The two others 12,19 have comparable values of MNM-Mortality ratios of ours.…”

Section: Fetal Outcome Percentagecontrasting

confidence: 96%

“…In the present study, near miss incidence ratio is high (40.12) as compared to 16.32 and 4.17 in other studies (Table 6). 8,12 Comparing the odds ratio with 3 other studies, our results are statistically significantly different than others [8,12,19] with respect to MNM ratio. This indicates our MNM ratio is at par than other Indian studies conducted from year 2017 to 2020.…”

Section: Fetal Outcome Percentagecontrasting

confidence: 80%

“…21 The critical care services in form of blood and components, surgical interventions, inotropy support, ventilator, ICU stay, dialysis and fourth-generation antibiotics given to MNM in our Institute were found significantly correlated with various etiological factors compared to other studies, specialy recent reports in 2021 and 2022 (Table 7). 10,18 Life-saving surgeries like obstetric hysterectomy in cases of PPH, laparotomy for uterine rupture, and salpingectomy in cases of tubal ectopic could save many young lives in the era of modern obstetrics.Major surgical interventions like obstetric hysterectomy and laparotomy were required in 75% of MNM and 87.5% of women required a massive blood transfusion in another study; 5 while 42 and 32% urgent surgical interventions were major treatment in others [8,10]. An Indian study showed a laparotomy percentage of 12.15% in the MNM.…”

Section: Fetal Outcome Percentagementioning

confidence: 91%

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Study of Maternal Near Miss by Near Miss: Mortality Ratio, Exploring Quality of Care

Shany John J S,

Vandana Patidar,

Mahadik

2023

CIJMR

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Introduction: Near Miss being a proxy indicator of MMR, evaluation of facility services and Near Missnumbers was carried out in a teaching hospital in Central India. Sustainable Development Goal targetsMMR less than 70 by year 2030. This study aims to report and evaluate causal factors of maternal nearmiss ratio, maternal death ratio as it is a sensitive indicator of medical care given by the facility. Criticalcare services were quantified in this study.Methods: 4422 number of delivery files occurring over a period of 3 years were included in aretrospective manner. Maternal deaths were 21, Near Miss 170 and live births 4237. Variables studiedwere Maternal near miss ratio, Maternal near miss mortality ratio, mortality index and final diagnosisof each patient. The number of blood components, urgent surgery, ventilator, ICU stay, dialysis andnumber of fourth-generation antibiotics were studied for calculating risk factors against variousdiagnoses. Bi-variate analysis and percents were statistical tools used.Results: Maternal near miss ratio was 40.12, the maternal near miss mortality ratio 8.09:1, and mortalityindex 10.99%. The findings included 85.3% blood transfusion use, 61.8% surgical intervention, 38.2%inotrope, 32.4% ventilator, 96% ICU and 96% fourth generation antibiotic use. Odds for comparisonof services given for various different etiological conditions with respect to MNM ratio and MNMMortalityratio was statistically significant for our data; giving a positive and better ranking to servicesin this Institute.Conclusion: The maternal near-miss ratio of 40.12, Mortality index of 10.99% and MNM – Mortalityratio 8:1 are the major findings of this study.Odds for comparative statements between other reportsand others showed statistical significance.

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Section: Fetal Outcome Percentagecontrasting

confidence: 96%

Section: Fetal Outcome Percentagecontrasting

confidence: 80%

Section: Fetal Outcome Percentagementioning

confidence: 91%

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Study of Maternal Near Miss by Near Miss: Mortality Ratio, Exploring Quality of Care

Shany John J S,

Vandana Patidar,

Mahadik

2023

CIJMR

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“…The situation is alarming probably because of antibiotic resistance and late arrivals. Similar findings were noted by Uma Devi S et al 12 Most of the patients who died due to eclampsia already arrived late and had untreated hypertension during pregnancy. Hence, early recognization of alarming signs should be done at grass root level.…”

supporting

confidence: 87%

Analysis of maternal deaths over a period of three years at a tertiary care centre of Uttarakhand, India

Ramola¹,

Jain²,

Gupta³

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Globally, about 800 women die every day of preventable causes related to pregnancy and childbirth; 20 per cent of these women are from India. The study is aimed at evaluating maternal deaths over a period of three years at a tertiary care centre of Dehradun, India.Methods: This was a retrospective study conducted in the Department of Obstetrics and Gynecology at SGRRIMHS, Dehradun. The case record files of all maternal deaths from January 2015 to December 2017 was obtained from medical record section of the hospital. Maternal age, parity, educational status, antenatal registration, mode of delivery, admission death interval and causes of each maternal death was noted and analysed statistically.Results: There were 48 maternal deaths from January 2015 to December 2017.Maximum deaths were in the age group of 21-25 years. The maternal mortality ratio over a period of three years was 671 per one lac live births. Most of the maternal deaths were due to direct causes like hemorrhage , eclampsia followed by sepsis.Conclusions: Most of the maternal deaths are preventable. High risk cases should be identified at root level and early referral should be the moto. All women need access to antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth. To avoid maternal deaths, unwanted and too-early pregnancies should be avoided. All women, including adolescents, should have access to contraception, safe abortion services to the full extent of the law, and quality post-abortion care. It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for both the mother and the baby.

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“…As transport facilities improved in recent years, so patients reported hospital in state, in which they can be saved but still it has to improve much more. 1%) 7,8. Most of maternal deaths cases were unbooked (70.6%).…”

mentioning

confidence: 98%

A retrospective analysis of maternal deaths over a period of five years at a tertiary care hospital of central India

Yadav

Rajput

Tiwari

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Maternal mortality is one of the important indicators used for the measurement of maternal health. The present study was conducted to analyse the maternal deaths over a period of five years in a tertiary care centre, GMH Rewa, Madhya Pradesh.Methods: A retrospective observational study was conducted in department of Obstetrics and Gynaecology, Shyam Shah Medical College and associated Gandhi Memorial Hospital, Rewa. The case records of all maternal deaths between January 3013 to December 2017 were collected from hospital medical records and studied. Data were analyzed statistically.Results: There were 214 maternal deaths from January 3013 to December 2017.The average maternal mortality ratio over a period of five years was 471.5 per one lac live births. Majority of maternal deaths were from toxaemia 33.2%, haemorrhage 26.2%, anaemia 16.3% and sepsis 12.6%.Conclusions: The present study highlights the importance of early antenatal registration of all pregnancies and regular follow up of cases by trained staff. Active management of high-risk groups by frequent antenatal visits, fluid and component transfusions, aggressive management of infection and closer monitoring of women in labor. Higher fertility and unwanted pregnancies should be reduced through family welfare services and easy availability of Medical termination of pregnancy services to be ensured. Analysis of every maternal death through maternal death audit should be carried out.

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Burden and causes of maternal mortality and near-miss in a tertiary care centre of Kerala, India

Cited by 3 publications

References 12 publications

Study of Maternal Near Miss by Near Miss: Mortality Ratio, Exploring Quality of Care

Study of Maternal Near Miss by Near Miss: Mortality Ratio, Exploring Quality of Care

Analysis of maternal deaths over a period of three years at a tertiary care centre of Uttarakhand, India

A retrospective analysis of maternal deaths over a period of five years at a tertiary care hospital of central India

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