DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20184120

Study of maternal mortality in a tertiary care hospital (GMERS-Dharpur, Patan, Gujarat, India): a three-year review

Parul S. Jani

Abstract


Background: Epidemiological data related to maternal mortality is valuable in each set up to design the progress to maternal mortality. This study was done to evaluate maternal death over period of 3 years at tertiary care centre of North Gujarat, India.

Methods: This was retrospective study conducted at department of Obstetrics and Gynecology at GMERS medical college Dharpur, Patan (N.G.), India. Epidemiological data was collected from hospital register from January-15 to Dec-17 of maternal death in the hospital maternal age, parity, educational status, ANC registration, mode of delivery, admission death interval and direct and indirect causes and maternal deaths were noted and analyzed statistically.

Results: There were 41 maternal deaths from Jan-15 to Dec-17. Maximum deaths were in 21-30 age group with multipara, unbooked and illiterate patients. Majority of maternal deaths are due to hemorrhage, eclampsia and sepsis.

Conclusions: Many different factors interact in a complex way to increase the risk of death of pregnant women. Regular ANC, early identification of complication and timely referral, delivery by skill birth attendant and adequate post-partum case and follow up are required. To avoid maternal death unwanted pregnancy, too early pregnancy should be avoided adequate counseling and contraception facility also required for sepsis prevention, safe abortion services according to the law and quality post abortion care. There is a wide scope of improvement as most of the maternal deaths are preventable.


Keywords


JSSK, Maternal mortality, Maternal mortality ratio, NRHM (National Rural Health Mission)

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References


United Nations. The Universal declaration of human rights. New York: United Nations; 1948. Available at: http//www.un.org/Overview/rights.html.

Ronsmas C, Graham WJ. Lancet Maternal Survival Series group. Maternal Mortality: who, when, where, and why. Lanet. 2006;368(9542):1189-200.

3) Special Bulletin on Maternal Mortality in India 2007-09: Sample Registration System, Office of Registrar General, India.2011 Jun. Available at http://censusindia.gov.in/Vital_Statistics/SRS_Bulletins/Final-MMR%20Bulletin-2007-09_070711.pdf

Mc Clure EM, Goldenberg RL, Bann CM. Maternal mortality, stillbirth and measures of obstetric care in developing and developed countries. Int J Gynecol Obstet. 2007;96(2):139-46.

Khosla AH, Mehara R, Dua D, Gupta P. Maternal morbidity and Mortality: an assessment of prevalence and aietiological factors. Obs Gynae Today 2006;11:447-9.

RGI (2006) Registrar General/centre for Global Health research, University of Toronto, New Delhi: Registrar General of India. Available at http://cghr.org/wordpress/wp-content/uploads/2011/07/MDS-Study-Protocol.pdf

WHO, UNICEF, UNFPA, World Bank (2012) Trends in Maternal Morality: 1990 to 2010Geneva: World Health Organization. Available at http://www.who.int/reproductivehealth/publications/monitoring/9789241503631/en/

IIPS (2010) District level household and facility survey (DLHS-3) 2007-2008: India, Mumbai: International Institute for Population Science. Available at http://rchiips.org/pdf/INDIA_REPORT_DLHS-3.pdf

Special Bulletin on Maternal Mortality. Government of India. Available at http//www.censusindia.gov.in/vital statistics/SRS—Bulletins/MMR-Bulletin-2010-12.pdf.

National Rural Health Mission: Framework for implementation 2005-2012; New Delhi: Ministry of Health and Family Welfare, Government of India. Available at: nrhm.gov.in/nhm/nrhm-framework-for-implimentation.html.

UN Sustainable Development Goals. Available at: http//www.un.org./sustainabledevelopment/health/.

Kaul V, Bagga R, Jain V, Gopalan S. The impact of primary postpartum haemorrhage in “near-miss” morbidity and mortality in a tertiary care hospital in North India. Indian J Med Sci. 2006,60:233-40.

Jain M, Maharahaje S. Maternal mortality: A retrospective analysis of 10 years in a tertiary hospital. Indian J Prev Soc Med. 2003;34(3-4):103-11.

Jadhav AJ,Rote PG, Maternal mortality—changing trends. J Obstet Gynecol India. 2007:57(5):398-400.

Pal A, Ray P, Hazra S, Mondal TK. Review of changing trends in Maternal Mortality in a rural medical college in West Bengal. J Obstet Gynecol India, 2005:55(6):521-4.

Onkewhor JU, Gharoro EP. Changing trends in Maternal Mortality in a developing country. Niger J Clin Pract. 2008;11(2):111-20.

Khumanthem PD, Chanam MS, Samjetshabam RD. Maternal mortality and its causes in a tertiary centre: J Obstet Gynecol India.2012;62(2):168-71.

Shah RJ, AliI, Banday A, Fazili A, Khan I. Analysis of maternal mortality in a small teaching hospital attached to tertiary care hospital. Indian J Community Med. 2008;33(4):260-2.

Patel A, Shukla D, Hazara M. Retained placenta;the third stage threat(12 years study). J Obstet Gynecol India. 1991;41:606-10.

Sharma S, Aherwar R, Jawade S, Maternal and fetal outcome in jaundice complicating pregnancy: A prospective study. Int. J Reprod Contracept Obstet Gynecol. 2016;5(4):1084-7.

Pal SJ, Rao MA, A three year review of maternal mortality in a district hospital on the west coast in south India( April 2011-2014). Int J Innov Res Dev. 2014;3(7):15-21.

Patra S, Kumari A, Trivedi SS, Puri M, Sarin SK. Maternal and fetal outcome in pregnant women with acute hepatitis E virus. Ann Intern Med. 2007;147(1):28-33.