Maternal mortality

Jashnani, Kusum D.; Rupani, A B; Wani, Reena

doi:10.4103/0022-3859.48435

Cited by 25 publications

(34 citation statements)

References 12 publications

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“…In the present study, HBV infection accounted for over 65% cases of FVHP. FVHP has become one of the major indirect causes of maternal and fetal death [15,16]. In the present study, the prognosis of acute FVHP is poorest, followed by the subacute and chronic types, which is similar to findings from another study [17].…”

Section: Discussionsupporting

confidence: 92%

Analysis of prognosis‐associated factors in fulminant viral hepatitis during pregnancy in China

Yang

Deng

et al. 2011

Intl J Gynecology & Obste

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Section: Discussionsupporting

confidence: 92%

Analysis of prognosis‐associated factors in fulminant viral hepatitis during pregnancy in China

Yang

Deng

et al. 2011

Intl J Gynecology & Obste

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“…This high MMR may be inherent to hospital based MMRs due to high risk status and complicated cases of women delivering in hospital [10]. The findings are comparable to other facility based studies in Pakistan and Nigeria where MMRs were found to be 1,650 and 1,747 per 100,000 live births respectively [11, 12].…”

Section: Discussionsupporting

confidence: 54%

Maternal mortality at muhimbili national hospital in Dar-es-Salaam, Tanzania in the year 2011

Pembe

Paulo

Dmello³

et al. 2014

BMC Pregnancy Childbirth

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BackgroundImproving maternal health is one of the eight millennium development goals adopted at the millennium summit in the year 2000. Within this frame work, the international community is committed to reduce the maternal mortality ratio by 75% between 1990 and 2015. The objective of this study was to determine the maternal mortality ratio, classify causes of maternal deaths and assess substandard care factors at Muhimbili National Hospital (MNH), Dar-es-Salaam in Tanzania.MethodsA retrospective review of all maternal death records of cases that occurred from 1st January to 31st December 2011 was done.ResultsThere were 10,057 live births, 155 maternal deaths and hence MMR of 1,541 per 100,000 live births. Direct causes of maternal deaths were classified in 69.5% of the maternal deaths. Of the direct causes, preeclampsia/eclampsia was the major cause (19.9% of all deaths), followed by post partum haemorrhage (14.9%), abortion complications (9.9%) and sepsis (9.2%). Among the indirect causes anaemia was the leading cause (11.3%) of all deaths, followed by HIV/AIDS (9.9%). Substandard care factors contributing to deaths were identified in 116 (82.3%) of all cases. Among these 28 had patient factors only, 71 medical service factors while 17 had both patient and medical service substandard care factors. The common factors from the woman’s side included delay in seeking care (73.3%) and complete lack of antenatal care (11.1%). Of the medical service factors, inadequate (26.1%) or no blood for transfusion (19.3%), delay in receiving treatment (18.3%) and mismanagement (17%) were the common factors.ConclusionThere is a high maternal mortality ratio at MNH. Hypertensive disorders of pregnancy, post partum haemorrhage and anaemia are the leading causes of maternal deaths in this institution. Multiple substandard care factors identified both at individual and health care service levels that contributed to maternal deaths. There is a need for increasing efforts in the fight to reduce maternal deaths at the institution. A more pro-active role from the referring facilities in the region is needed.

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“…That many referrals were from private hospitals corroborates claims that private providers lack the capacity to manage serious illness [53,57,58]. At the same time, peripheral public hospitals lack emergency care facilities and are also major referrers [59]. …”

Section: Discussionmentioning

confidence: 70%

Stillbirths and newborn deaths in slum settlements in Mumbai, India: a prospective verbal autopsy study

Bapat

Alcock

et al. 2012

BMC Pregnancy Childbirth

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BackgroundThree million babies are stillborn each year and 3.6 million die in the first month of life. In India, early neonatal deaths make up four-fifths of neonatal deaths and infant mortality three-quarters of under-five mortality. Information is scarce on cause-specific perinatal and neonatal mortality in urban settings in low-income countries. We conducted verbal autopsies for stillbirths and neonatal deaths in Mumbai slum settlements. Our objectives were to classify deaths according to international cause-specific criteria and to identify major causes of delay in seeking and receiving health care for maternal and newborn health problems.MethodsOver two years, 2005–2007, births and newborn deaths in 48 slum areas were identified prospectively by local informants. Verbal autopsies were collected by trained field researchers, cause of death was classified by clinicians, and family narratives were analysed to investigate delays on the pathway to mortality.ResultsOf 105 stillbirths, 65 were fresh (62%) and obstetric complications dominated the cause classification. Of 116 neonatal deaths, 87 were early and the major causes were intrapartum-related (28%), prematurity (23%), and severe infection (22%). Bereavement was associated with socioeconomic quintile, previous stillbirth, and number of antenatal care visits. We identified 201 individual delays in 121/187 birth narratives (65%). Overall, delays in receiving care after arrival at a health facility dominated and were mostly the result of referral from one institution to another. Most delays in seeking care were attributed to a failure to recognise symptoms of complications or their severity.ConclusionsIn Mumbai’s slum settlements, early neonatal deaths made up 75% of neonatal deaths and intrapartum-related complications were the greatest cause of mortality. Delays were identified in two-thirds of narratives, were predominantly related to the provision of care, and were often attributable to referrals between health providers. There is a need for clear protocols for care and transfer at each level of the health system, and an emphasis on rapid identification of problems and communication between health facilities.Trial registrationISRCTN96256793

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Maternal mortality

Cited by 25 publications

References 12 publications

Analysis of prognosis‐associated factors in fulminant viral hepatitis during pregnancy in China

Analysis of prognosis‐associated factors in fulminant viral hepatitis during pregnancy in China

Maternal mortality at muhimbili national hospital in Dar-es-Salaam, Tanzania in the year 2011

Stillbirths and newborn deaths in slum settlements in Mumbai, India: a prospective verbal autopsy study

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