Maternal Death Reviews of a Tertiary Care Hospital
DOI:
https://doi.org/10.31729/jnma.2034Abstract
Introduction: All pregnant women are at risk of obstetrical complications which occurs during labour and delivary that lead to maternal death. Here to report a 10 year review of maternal mortality ratio in "Paropakar Maternity and Women's Hospital (PMWH)" Thapathali Kathmandu, Nepal.
Methods: Medical records of 66 maternal deaths were reviewed to study the likely cause of each death over the study period.
Results: There were a total of 66 maternal deaths. While 192487 deliveries conducted over the 10 year period. The maternal mortality ratio (MMR) was 356.64/100000 live birth. The highest MMR of 74.22/100,000 was observed in 2059 and lowest was 17.42/100,000 in 2068 B.S. Leading cause of MMR was remained hemorrhage accounting for 30.30% followed by eclampsia 24.24%. Sepsis, suspected cases of pulmonary embolism and amniotic fluid embolism each contributing 15.15%, 4.54% and 3.03% respectively. Where as anesthetic complication and abortion constiuates 6.06 % each equally for maternal death. The death noted in older women (30+year) were 36.36%. Primipara accounted for more deaths (51.51%).
Conclusions: The fall in maternal mortality rate has been observed except for year 2063 BS. Haemorrhage is the main contributing cause behind maternal mortality.
References
2. Rosmans C, Graham WJ. Maternal mortality: who, when, where, why. Lancet 2006; 368:1189-200.
3. Graham WJ. Now or never: the case for measuring maternal mortality. Lancet 2002; 359:701-4.
4. World Health organization. The World Bank. Maternal mortality 1990 to 2008: estimates developed by WHO, UNICEF, UNFPA and The World Bank. Geneva: WHO; 2010.
5. Nepal maternal mortality and morbidity study 2008/09 - Summary of
preliminary findings; Source: United Kingdom Department for
International Development (DFID); Government of Nepal; United States
Agency for International Development (USAID).
6. Vink N.M, Hendrik C.C. de Jonge, Ter Haar R, Chizimba E.M and Stekelenburg J. Maternal death reviews at a rural hospital in Malawi. Int. J of Gyn and Obst 2013 Jan; vol. 120(1): 74-7.
7. Cross S, Bell JS, Graham WJ. What you count is what you target: the implications of maternal death classification for tracking progress towards reducing maternal mortality in developing countries. Bull. World Health Organ 2010;88(2):147-53.
8. Bano B, Chaudhri R, Yasmeen L, Shafi F, Ejaz L. a study of maternal ortality in 8 principal hospitals in Pakistan in 2009. Int J Gynaecol Obstet. 2011; 114: 255-9.
9. Government of Nepal Ministry of Health and Population. Department of Health Family Health Division. Teku Kathmandu. "Ama Surakchha Karyakram" Guideline 2065.
10.kullima A A, Kawuwa MB, Audu BM, Geldam AD, Mairiqa AG. Trends in maternal mortality in a tertiary institution in Northern Nigeria. Ann Afr. Med 2009 Oct-Dec; 8(4): 221-4.
11.Hussian J, Bell J, Jang MD, Mesko N, Amery J, Graham W. An appraisal of maternal mortality decline in Nepal. PloS one 20011;6:e1989.
12.Choudhury ME, Ahmed A, Kalin N, Koblinsky M. Causes of maternal mortality decline in Matlab, Bangladesh. J of Health Pop Nuter 2009:27:108-123.
13. Jafarey SN. Maternal mortality in Pakistan:complication of available data. J Pak Med Assoc 2002:52:539-44.
14. Walfish M, Neuman A, Wlody D. Maternal haemorrhage. Oxford J. Med. BJA 2009: Vol. 103 (1); 147-156 .
15.Adekanle DA, Adeyemi AS, Fadero FF. Ante-partum haemorrhage and pregnancy outcome in Lautech teaching Hospital, southwestern Nigeria. J Med. Sci. 2011 Dec Vol.2(12);1243-7.
16.Dolea C Stein C. Global burden of maternal sepsis in the year 2000.Evidence and Information for Policy(EIP) World Health Organization, Genava July 2003.
17.Geoffrey C, Steer PJ. Maternal mortality. Turnbull Obstetrics 3rd edition. Edinburg: Churchill Livingstone, 2001:741-752.
Downloads
Published
How to Cite
Issue
Section
License
JNMA allow to read, download, copy, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose. The author(s) are allowed to retain publishing rights without restrictions. The JNMA work is licensed under a Creative Commons Attribution 4.0 International License. More about Copyright Policy.