Facility‐based review of 296 maternal deaths at a tertiary centre in <scp>I</scp>ndia: Could they be prevented?

Goswami, Deepti; Rathore, Asmita; Batra, Swaraj; Dubey, Chandan; Tyagi, Shantanu; Wadhwa, Leena

doi:10.1111/jog.12099

Cited by 9 publications

(16 citation statements)

References 18 publications

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“…The proportions are higher compare to previous some studies 7,11,18,20 , but represents a speciifc group dealt at peripheral secondary level or EmONC facilities of Bangladesh. The findings deserve attention for immediate actions by enhancing capacity at secondary level facilities of Bangladesh in managing obstetric complications with a focus to haemorrhage and eclampsia.…”

Section: Fig-3: Delay In Decision Making and Transfer To Referral Famentioning

confidence: 76%

“…The facility death review helped implementing remedial actions based on audit data and improved quality of care at facilities 8,11,17,27 . The death review process successfully identified medical causes and health system gaps.…”

Section: Fig-3: Delay In Decision Making and Transfer To Referral Famentioning

confidence: 99%

“…Later in 2013, WHO also published an updated health system model named "Maternal Death Surveillance and Response" (MDSR) that also covers both community and facility level maternal deaths for surveillance, and subsequent death audit that follows response for averting similar death in future 9 . Many a developed and developing countries experienced similar maternal death audit with successes [10][11][12][13][14][15][16] .…”

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confidence: 99%

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Factors Associated with Maternal Deaths in District and Upazila Hospitals of Bangladesh

Halim

Biswas²,

Abdullah³

et al. 2017

Bangladesh J Obstet Gynaecol

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Objective(s): Aim of the study was to use death review to explore medical causes and three delay causal factors responsible for maternal deaths in district or below level health facilities of Bangladesh.Methods: Government health workers conducted facility based death review in 56 maternal deaths occurred during 2010-2012 in four district and five upazila (EmONC) health facilities of Bangladesh. The data was analyzed to assess the causal relationship between the medical causes and the three delays factors in maternal mortality.Results: Majority of the mothers died was young (89.3%; below age 30 years) and died during first pregnancy (78.6%) and postpartum period (71.4%). Postpartum hemorrhage and preeclampsia-eclampsia were the foremost causes of maternal deaths at district level facilities of Bangladesh. Seventy two percent of them arrived the hospitals in a travel time <2 hour from home or first care-centre when 88% of cases had an unstable general condition. 72% of them received treatment within one hour of admission in the hospital. The patients records reflected that only a few patients received life-saving interventions like blood transfusion, fundal message, and/or oxytocic in postpartum haemorrhage or magnesium sulphate in eclampsia. The study also observed a poor documentation in all the facilities, which was a challenge for death review.Conclusions: The study suggested improving quality of care and increasing availability of skills to manage the complicated cases in district and below level EmONC hospitals with focused interventions for postpartum haemorrhage and preeclampsia-eclampsia. The facility death review will be useful in identifying causal factors, the third delay factors and service gaps and to respond accordingly to avert similar deaths.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(1) : 16-22

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Section: Fig-3: Delay In Decision Making and Transfer To Referral Famentioning

confidence: 76%

Section: Fig-3: Delay In Decision Making and Transfer To Referral Famentioning

confidence: 99%

mentioning

confidence: 99%

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Factors Associated with Maternal Deaths in District and Upazila Hospitals of Bangladesh

Halim

Biswas²,

Abdullah³

et al. 2017

Bangladesh J Obstet Gynaecol

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“…Missed diagnosis leads to tubal rupture, hemoperitoneum and hemorrhagic shock. It is an important cause of maternal mortality in the first trimester of pregnancy in Western as well as in Asian countries . Twin ectopic pregnancy is a rare occurrence with an estimated incidence of 1 in 20 000 spontaneous pregnancies .…”

Section: Introductionmentioning

confidence: 99%

“…It is an important cause of maternal mortality in the first trimester of pregnancy in Western as well as in Asian countries. 1 Twin ectopic pregnancy is a rare occurrence with an estimated incidence of 1 in 20 000 spontaneous pregnancies. 2 We describe one such case and discuss an interesting observation that has implications for the management of this rare type of ectopic pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Twin tubal pregnancy: A large unruptured ectopic pregnancy

Goswami

Agrawal

Arora

2015

J of Obstet and Gynaecol

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Twin ectopic pregnancy is a rare occurrence, with an estimated incidence of 1 in 20 000 spontaneous pregnancies. We describe a case of unilateral twin ectopic pregnancy in which the gravid fallopian tube showed no signs of tubal rupture despite marked tubal distension. A 25-year-old woman presented with clinical features suggestive of large right-sided tubal ectopic pregnancy. Serum β-human chorionic gonadotropin was 10 800 IU/mL. Laparotomy revealed markedly distended right fallopian tube. There was no hemoperitoneum. The tube contained twin gestational sacs. The crown-rump length of the embryos was 2 cm. The ectopic gestation was thus unique, in that despite marked tubal distension, the trophoblastic invasion was not significant to cause tubal rupture. There may be a role for medical management based on individual gestational sac size in selected cases of twin tubal pregnancy in which there is no evidence of hemoperitoneum.

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