Trends in Maternal Mortality and Impact of Janani Suraksha Yojana (JSY) on Maternal Mortality Ratio in a Tertiary Referral Hospital

Guin, Gita; Sahu, Bharti; Khare, Shashi; Kavishwar, Arvind

doi:10.1007/s13224-012-0221-1

Cited by 15 publications

(15 citation statements)

References 2 publications

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“…It is however 1.46 less than that obtained by Tebeu and collaborators in a secondary-care-facility-based Cameroonian study [25], and 2.76 times less than that of an Indian tertiary facility-based study [26]. Facility-based MMR are generally higher than community-based estimates because of referrals to these structures of more severe cases.…”

Section: Discussionmentioning

confidence: 63%

Outcome of deliveries among adolescent girls at the Yaoundé central hospital

Fouelifack

Tameh

Mbong

et al. 2014

BMC Pregnancy Childbirth

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BackgroundAdolescent pregnancies are a growing public health problem in Cameroon. We sought to study the outcome of such pregnancies, in order to inform public health action.MethodsA cross-sectional analysis of 5997 deliveries which compared the outcome of deliveries in adolescent (10–19 years old) pregnant women registered at the Yaoundé Central Hospital between 2008 and 2010 to that of their non-adolescent adult (≥ 20 years old) counterparts. Variables used for comparison included socio-demographic and obstetric characteristics of parturients, referral status, and maternal and fetal outcomes. Predictors of maternal and of perinatal mortality were determined through binomial logistic modeling.ResultsAdolescent deliveries represented 9.3% (560) of all pregnancies registered. Adolescent pregnancies had significantly higher rates of both gestational duration extremes: preterm as well as post-term deliveries (29.3% versus 24.5%, p = 0.041 OR 1.28 95% CI 1.01-1.62 and 4.9 versus 2.4%, p = 0.014 OR 2.11 95% CI 1.46-3.87 respectively). Both groups did not differ significantly with respect to mean blood loss, rates of cesarean or instrumental deliveries. Adolescent deliveries however required significantly twice as many episiotomies (OR 2.15 95% CI 1.59-2.90). The likelihood of perineal tears in the adolescent group was significantly higher than that in the adult group on assuming episiotomies done would have been tears if they had not been carried out (OR 1.45 95% CI 1.16-1.82). Adolescent parturients had a higher likelihood of apparent fetal death at birth as well as perinatal fetal death after resuscitation efforts (AOR 1.75 95% CI 1.25-2.47 and AOR 1.69 95% CI 1.17-2.45 respectively).Comparisons of pregnancy outcomes between early (10–14 years), middle (15–17 years) and late adolescence (18–19 years) found no significant differences. Predictors of maternal death included having been referred, having had ≥5 deliveries and preterm deliveries. These were also predictors of perinatal death, as well as being a single mother, primiparous, and multiple gestations.ConclusionsAdolescent pregnancies in Cameroon compared to those in adults are associated with poorer outcomes. There is need for adolescent-specific services to prevent teenage pregnancies as well as interventions to prevent and manage the above mentioned predictors of in-facility maternal and perinatal mortality.

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Section: Discussionmentioning

confidence: 63%

Outcome of deliveries among adolescent girls at the Yaoundé central hospital

Fouelifack

Tameh

Mbong

et al. 2014

BMC Pregnancy Childbirth

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“…The overall incidence of liver disorder in pregnancy in our institution was 1.96% as per the study conducted by Sharma et al 10 But in the studies by Ashok V, Guin G, Purandare N, Pal SJ, the major indirect cause of death was anaemia with the percentage varying from 15% to 65%. [11][12][13][14] Correction of anaemia at grass root level is very important to prevent these deaths. MCH is essential as regular ANC check-ups can help detect and correct anaemia.…”

Section: Resultsmentioning

confidence: 99%

Maternal mortality: a retrospective analysis of 6 years in a tertiary care centre

Parmar

Shriastava

Kanhere

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Pregnancy, although being considered a physiological state, carries the risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labour or thereafter. Worldwide 3,03,000 women are dying of pregnancy related complication annually.Methods: The medical records of all maternal death occurred over a period of last five years between August 2011 to August 2017 in the Department of Obstetrics and Gynaecology at our tertiary care hospital were reviewed and analysed.Results: It is observed that out of total 30 patients, 24 (80%) deaths were from 20-30 year of age followed by 5 (16.67%) deaths from above 30 years of age. In the study period, 40% of maternal deaths were due to direct causes, haemorrhage (8/12; 66.67%) was main direct causes of obstetric death.Conclusions: The complications leading to maternal death can occur without warning at any time during pregnancy and childbirth. Most maternal deaths are preventable by optimum utilization of existing maternal and child health care facilities. Complications require prompt access to quality obstetric services equipped with life-saving drugs, intensive care unit, and the ability to provide blood transfusions and to perform surgical interventions as per the need.

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“…[10] Government ambulance (108) is neither being utilized by the people nor by the referring doctors. None of the patients were referred to the center in these ambulances.…”

Section: Discussionmentioning

confidence: 99%

Prepare and prevent rather than repair and repent: Study of maternal mortality in tertiary care hospital

Mundkur¹,

Rai²

2013

Int J Med Public Health

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Context: Maternal death signifi es the quality of healthcare provided in the population. It is the young, relatively healthy women who die of various reasons. Audit of such mortality would prevent the recurrence by taking appropriate measures. Aims: To fi nd the causes of maternal mortality. Settings and Design: Retrospective observational study. Materials and Methods: All maternal deaths in a tertiary care referral center from January 2007 to September 2012 were studied for their demographic profi le and causes of death. Results: All 62 women were referred from other healthcare units. Twenty-nine patients died within 24 h of admission and 33 women died after 24 h of admission. Death of 34 patients was due to direct obstetric causes and of 26 patients due to indirect obstetric causes. There were 2 maternal deaths due to accidental causes. Conclusions: The corrective action to prevent the recurrence of such deaths should be taken. Sepsis was found to be the commonest cause for maternal mortality followed by hemorrhage. It important to note that, in the present study, all mothers received antenatal care, had hospital delivery (none had home delivery), no teenage pregnancy or grand multigravidas, and no obstructed labor or rupture uterus, and yet they died. There is a change in the trend of causes of maternal mortality. Strengthening of the fi rst referral units with equipment, blood bank, and adequately competent staff should be of prime importance. Continued medical education of the medial personnel at the periphery is required. Maternal deaths occur in inspite of atenatal care and hospital delivery which is alarming. Contributing factors may be delay in referral or the travel which should be looked in to inorder to minimize such death of young women.Key words: Direct obstetric cause, indirect obstetric cause, maternal death, maternal mortality rate AbstractAnjali Mundkur, Lavanya Rai

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Trends in Maternal Mortality and Impact of Janani Suraksha Yojana (JSY) on Maternal Mortality Ratio in a Tertiary Referral Hospital

Abstract: Objective To analyse the impact of Janani Suraksha Yojana (JSY) on Maternal Mortality Ratio (MMR). Design Retrospective analysis of maternal mortality.

Cited by 15 publications

References 2 publications

Outcome of deliveries among adolescent girls at the Yaoundé central hospital

Outcome of deliveries among adolescent girls at the Yaoundé central hospital

Maternal mortality: a retrospective analysis of 6 years in a tertiary care centre

Prepare and prevent rather than repair and repent: Study of maternal mortality in tertiary care hospital

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