A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat

Kanika P. Kachhwaha; Mahima Jain

doi:doi:10.11648/j.jgo.20190704.11

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A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat

Kanika P. Kachhwaha, Mahima Jain

Published in Journal of Gynecology and Obstetrics (Volume 7, Issue 4)

Received: 10 April 2019 Accepted: 4 June 2019 Published: 20 June 2019

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Abstract

Maternal mortality is still a big health concern in developing world. The state of maternal health represents overall state of women’s right in health, social and economic realms. If the causes of death can be addressed and are found to be preventable it indicates negligence on the part of government and the entities that have the power to implement the changes. To determine factors and causes of maternal mortality this retrospective observational study was conducted in the department of obstetrics and gynaecology, BJ medical college. Maternal mortalities from October 2016 to March 2018 (18 months) were analysed with respect to factors like locality, literacy, parity, ANC care, time after admission, type of delay (according to maternal death review form) and causes of death (direct and indirect causes of MMR). Total 92 maternal deaths were studied and that gave a MMR of 468 per 1,00,000 live births. Maximum deaths occurred in patients who were in the age group of 20-34 (83.1%), rural locality (71%), Irregular with ANC visits (74%), multigravida (56.5%), within 24 hours of delivery (46.7%) and those who had type 1 delay (delay in decision making to seek help, 78.3%). More of deaths occurred in post partum (84.8%) and in vaginal mode of delivery (47.4) Vs Caesarean section (46.3). Direct obstetric causes of death (57.6%) were of deaths which included hypertensive disorders (29.3%), haemorrhage (19%) and others. Indirect causes accounted for 42.4% deaths which included hepatitis (21.7%), heart diseases (9.8%) etc. Early intervention and diagnosis with timely management are essential to reduce morbidity and hence maternal mortality. Special attention should be given to Routine Antenatal care (RANC) and more specifically to Focussed Antenatal Care (FANC)). Lack of expertise at primary level with lack of proper referral system adds to the cause.

Published in	Journal of Gynecology and Obstetrics (Volume 7, Issue 4)
DOI	10.11648/j.jgo.20190704.11
Page(s)	100-103
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Maternal Mortality, Maternal Deaths, Gynaecology, Obstetric

References

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[3]	Max Roser and Hannah Ritchie (2019) - "Maternal Mortality". Published online at OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/maternal-mortality' [Online Resource].
[4]	Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A, et al. Lancet. 2016; 387 (10017): 462-74.
[5]	Khandale SN et al. Int J Reprod Contracept Obstet Gynecol. 2017 Apr; 6 (4): 1610-1613.
[6]	United Nations Development Programme. Millenium Development Goals.
[7]	Betran AP, Wojdyla D et al, Maternal mortality at country level: an analysis based on WHO systemic review. BMC public health 2005; 5: 131.
[8]	Raina, Shahid Hamid, India's Health Status and Sustainable Development - Achievements and Challenges (March 17, 2017).
[9]	Rudan I, Lawn J et al. Gaps in policy-relevant information onburden of diseases in children: A systemic review. Lancet 2005; 365: 2031-40.
[10]	Glaziou P, Irvig L, Bain C, Colditz G. Frequency and rate. In: Systemic reviews in health care: a practical guide, 2^nd edn. Cambridge, UK: Cambridge University Press, 2001: 67-73.
[11]	Stroup DF, Berlin JA, Morton SC, Oikin I et al. Meta-analysis of observational studies in epidemiology. A proposal for reporting. JAMA 2000; 283: 2008-12.
[12]	Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study. Conde-Agudelo A, Belizan JM, Lammers C. American Journal of Obstetrics and Gynecology, 2004, 192: 342–349.
[13]	Global patterns of mortality in young people: a systematic analysis of population health data. Patton GC, Coffey C, Sawyer SM, Viner RM, Haller DM, Bose K, Vos T, Ferguson J, Mathers CD. Lancet, 2009, 374: 881–892.
[14]	Khandale SN, Kedar K. Analysis of maternal mortality: a retrospective study at tertiary care centre. Int J Reprod Contracept Obstet Gynecol 2017; 6: 1610-3.
[15]	Nair A, Doibale MK, Gujrathi VV, Inamdar IF, Shingare AD, Rajput PS. Study of maternal mortality in a tertiary care hospital in a district of Maharashtra. Int J Med Sci Public Health 2016; 5: 1851-1854.

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APA Style

Kanika P. Kachhwaha, Mahima Jain. (2019). A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat. Journal of Gynecology and Obstetrics, 7(4), 100-103. https://doi.org/10.11648/j.jgo.20190704.11

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ACS Style

Kanika P. Kachhwaha; Mahima Jain. A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat. J. Gynecol. Obstet. 2019, 7(4), 100-103. doi: 10.11648/j.jgo.20190704.11

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AMA Style

Kanika P. Kachhwaha, Mahima Jain. A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat. J Gynecol Obstet. 2019;7(4):100-103. doi: 10.11648/j.jgo.20190704.11

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@article{10.11648/j.jgo.20190704.11,
  author = {Kanika P. Kachhwaha and Mahima Jain},
  title = {A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {7},
  number = {4},
  pages = {100-103},
  doi = {10.11648/j.jgo.20190704.11},
  url = {https://doi.org/10.11648/j.jgo.20190704.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20190704.11},
  abstract = {Maternal mortality is still a big health concern in developing world. The state of maternal health represents overall state of women’s right in health, social and economic realms. If the causes of death can be addressed and are found to be preventable it indicates negligence on the part of government and the entities that have the power to implement the changes. To determine factors and causes of maternal mortality this retrospective observational study was conducted in the department of obstetrics and gynaecology, BJ medical college. Maternal mortalities from October 2016 to March 2018 (18 months) were analysed with respect to factors like locality, literacy, parity, ANC care, time after admission, type of delay (according to maternal death review form) and causes of death (direct and indirect causes of MMR). Total 92 maternal deaths were studied and that gave a MMR of 468 per 1,00,000 live births. Maximum deaths occurred in patients who were in the age group of 20-34 (83.1%), rural locality (71%), Irregular with ANC visits (74%), multigravida (56.5%), within 24 hours of delivery (46.7%) and those who had type 1 delay (delay in decision making to seek help, 78.3%). More of deaths occurred in post partum (84.8%) and in vaginal mode of delivery (47.4) Vs Caesarean section (46.3). Direct obstetric causes of death (57.6%) were of deaths which included hypertensive disorders (29.3%), haemorrhage (19%) and others. Indirect causes accounted for 42.4% deaths which included hepatitis (21.7%), heart diseases (9.8%) etc. Early intervention and diagnosis with timely management are essential to reduce morbidity and hence maternal mortality. Special attention should be given to Routine Antenatal care (RANC) and more specifically to Focussed Antenatal Care (FANC)). Lack of expertise at primary level with lack of proper referral system adds to the cause.},
 year = {2019}
}

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TY  - JOUR
T1  - A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat
AU  - Kanika P. Kachhwaha
AU  - Mahima Jain
Y1  - 2019/06/20
PY  - 2019
N1  - https://doi.org/10.11648/j.jgo.20190704.11
DO  - 10.11648/j.jgo.20190704.11
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 100
EP  - 103
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20190704.11
AB  - Maternal mortality is still a big health concern in developing world. The state of maternal health represents overall state of women’s right in health, social and economic realms. If the causes of death can be addressed and are found to be preventable it indicates negligence on the part of government and the entities that have the power to implement the changes. To determine factors and causes of maternal mortality this retrospective observational study was conducted in the department of obstetrics and gynaecology, BJ medical college. Maternal mortalities from October 2016 to March 2018 (18 months) were analysed with respect to factors like locality, literacy, parity, ANC care, time after admission, type of delay (according to maternal death review form) and causes of death (direct and indirect causes of MMR). Total 92 maternal deaths were studied and that gave a MMR of 468 per 1,00,000 live births. Maximum deaths occurred in patients who were in the age group of 20-34 (83.1%), rural locality (71%), Irregular with ANC visits (74%), multigravida (56.5%), within 24 hours of delivery (46.7%) and those who had type 1 delay (delay in decision making to seek help, 78.3%). More of deaths occurred in post partum (84.8%) and in vaginal mode of delivery (47.4) Vs Caesarean section (46.3). Direct obstetric causes of death (57.6%) were of deaths which included hypertensive disorders (29.3%), haemorrhage (19%) and others. Indirect causes accounted for 42.4% deaths which included hepatitis (21.7%), heart diseases (9.8%) etc. Early intervention and diagnosis with timely management are essential to reduce morbidity and hence maternal mortality. Special attention should be given to Routine Antenatal care (RANC) and more specifically to Focussed Antenatal Care (FANC)). Lack of expertise at primary level with lack of proper referral system adds to the cause.
VL  - 7
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Author Information

Kanika P. Kachhwaha

Department of Obstetrics and Gynaecology, Byramjee Jeejeebhoy Medical College & Civil Hospital, Ahmedabad, Republic of India
Mahima Jain

Department of Obstetrics and Gynaecology, Byramjee Jeejeebhoy Medical College & Civil Hospital, Ahmedabad, Republic of India

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APA Style

Kanika P. Kachhwaha, Mahima Jain. (2019). A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat. Journal of Gynecology and Obstetrics, 7(4), 100-103. https://doi.org/10.11648/j.jgo.20190704.11

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ACS Style

Kanika P. Kachhwaha; Mahima Jain. A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat. J. Gynecol. Obstet. 2019, 7(4), 100-103. doi: 10.11648/j.jgo.20190704.11

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AMA Style

Kanika P. Kachhwaha, Mahima Jain. A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat. J Gynecol Obstet. 2019;7(4):100-103. doi: 10.11648/j.jgo.20190704.11

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@article{10.11648/j.jgo.20190704.11,
  author = {Kanika P. Kachhwaha and Mahima Jain},
  title = {A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {7},
  number = {4},
  pages = {100-103},
  doi = {10.11648/j.jgo.20190704.11},
  url = {https://doi.org/10.11648/j.jgo.20190704.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20190704.11},
  abstract = {Maternal mortality is still a big health concern in developing world. The state of maternal health represents overall state of women’s right in health, social and economic realms. If the causes of death can be addressed and are found to be preventable it indicates negligence on the part of government and the entities that have the power to implement the changes. To determine factors and causes of maternal mortality this retrospective observational study was conducted in the department of obstetrics and gynaecology, BJ medical college. Maternal mortalities from October 2016 to March 2018 (18 months) were analysed with respect to factors like locality, literacy, parity, ANC care, time after admission, type of delay (according to maternal death review form) and causes of death (direct and indirect causes of MMR). Total 92 maternal deaths were studied and that gave a MMR of 468 per 1,00,000 live births. Maximum deaths occurred in patients who were in the age group of 20-34 (83.1%), rural locality (71%), Irregular with ANC visits (74%), multigravida (56.5%), within 24 hours of delivery (46.7%) and those who had type 1 delay (delay in decision making to seek help, 78.3%). More of deaths occurred in post partum (84.8%) and in vaginal mode of delivery (47.4) Vs Caesarean section (46.3). Direct obstetric causes of death (57.6%) were of deaths which included hypertensive disorders (29.3%), haemorrhage (19%) and others. Indirect causes accounted for 42.4% deaths which included hepatitis (21.7%), heart diseases (9.8%) etc. Early intervention and diagnosis with timely management are essential to reduce morbidity and hence maternal mortality. Special attention should be given to Routine Antenatal care (RANC) and more specifically to Focussed Antenatal Care (FANC)). Lack of expertise at primary level with lack of proper referral system adds to the cause.},
 year = {2019}
}

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TY  - JOUR
T1  - A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat
AU  - Kanika P. Kachhwaha
AU  - Mahima Jain
Y1  - 2019/06/20
PY  - 2019
N1  - https://doi.org/10.11648/j.jgo.20190704.11
DO  - 10.11648/j.jgo.20190704.11
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 100
EP  - 103
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20190704.11
AB  - Maternal mortality is still a big health concern in developing world. The state of maternal health represents overall state of women’s right in health, social and economic realms. If the causes of death can be addressed and are found to be preventable it indicates negligence on the part of government and the entities that have the power to implement the changes. To determine factors and causes of maternal mortality this retrospective observational study was conducted in the department of obstetrics and gynaecology, BJ medical college. Maternal mortalities from October 2016 to March 2018 (18 months) were analysed with respect to factors like locality, literacy, parity, ANC care, time after admission, type of delay (according to maternal death review form) and causes of death (direct and indirect causes of MMR). Total 92 maternal deaths were studied and that gave a MMR of 468 per 1,00,000 live births. Maximum deaths occurred in patients who were in the age group of 20-34 (83.1%), rural locality (71%), Irregular with ANC visits (74%), multigravida (56.5%), within 24 hours of delivery (46.7%) and those who had type 1 delay (delay in decision making to seek help, 78.3%). More of deaths occurred in post partum (84.8%) and in vaginal mode of delivery (47.4) Vs Caesarean section (46.3). Direct obstetric causes of death (57.6%) were of deaths which included hypertensive disorders (29.3%), haemorrhage (19%) and others. Indirect causes accounted for 42.4% deaths which included hepatitis (21.7%), heart diseases (9.8%) etc. Early intervention and diagnosis with timely management are essential to reduce morbidity and hence maternal mortality. Special attention should be given to Routine Antenatal care (RANC) and more specifically to Focussed Antenatal Care (FANC)). Lack of expertise at primary level with lack of proper referral system adds to the cause.
VL  - 7
IS  - 4
ER  -

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