Determinants of maternal deaths amongst mothers who suffered from post-partum haemorrhage: a community-based case control study

Abstract

Background: The WHO estimates that, of the 529 000 maternal deaths occurring every year 136 000 take place in India amongst which postpartum haemorrhage (PPH) being the most (29.6%) commonly reported complication. However deaths from PPH can be prevented. The purpose of this study was to identify the risk factors contributing to maternal deaths amongst women who develop PPH.Methods: This was a community based paired case-control study done in rural areas of Lucknow, UP (India) done in a period of one year. Thirty-one maternal deaths due to PPH (cases) were matched and compared with two mothers who survived from PPH (controls). Data was analysed using SPSS version 17.0 and Open Epi version 2.3. The appropriate significance test was applied using MacNemar test for paired data. Risk factors obtained significant in bivariate analysis were subjected to conditional multiple logistic regressions for adjustment and controlling the effect of confounding variables. Results have been given in form of unadjusted Odds ratio (UOR) and adjusted Odds ratio (AOR).Results: It was seen that the mothers who had taken ≥4 antenatal visits during the index pregnancy had a protective effect against deaths due to PPH. Home delivery raised the odds of death by seven times.Conclusions: Deaths due to PPH can be reduced by ensuring institutional delivery, good antenatal care and better referral facilities, especially for mothers from weaker sections of society.

Mortality and its predictors among mothers diagnosed with Postpartum Hemorrhage in Public Hospitals in Harari Region, Ethiopia

“…The tendency for mothers to die with PPH was 19 times more likely among mothers with prolonged labor than those mothers who had normal labor duration. This finding is different from the one conducted in Senegal and Mali where there was no association between prolonged labor and maternal death due to PPH (23). The reason for this discrepancy might be due to the difference in the health care settings and timely access to better health care that most of the participants were referred from Health centers found in rural areas which might take a prolonged time to arrive at the hospitals in our setting.…”

Maternal Deaths due to Obstetric Hemorrhage in Padang, Indonesia: A Case-Control Study

“…Lack of education of mothers was not found to be of any signifi cant role in maternal survival which has also been observed 18 However, their study showed that mothers and mother in-laws play a crucial role in decision making related to maternal well-being and husbands lack of education was refl ected as an important determinant of maternal survival. 18…”

“…Our study is in India and Madagascar. 18,11 Women who had routine antenatal check-ups can identify the risk factors of pregnancy such as age, parity, pregnancy intervals, anemia status, history of illness, previous labour history, and PPH history. The place of delivery needs to be discussed and planned according to the risk of PPH identifi ed during antenatal care.…”

“…However, there was a case of death who had home delivery and was assisted by family. Studies have indicated that home delivery 18 and unskilled birth attendants 21 are determinants leading to maternal death.…”