Online ISSN: 2515-8260

Keywords : Maternal mortality


Maternal mortality among COVID-19 patients in a tertiary care hospital: A retrospective study

Niveditha R, Manohar Rangaswamy, Sandyashree PK, Manikanta KV

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 851-857

Background: The new covid 19 strains having two mutations is highly infectious and the
ongoing disease has posed a huge threat to global public health, causing higher rates of
morbidities and mortalities. Keeping this in mind, this study is planned to understand the
causes leading to maternal mortality due to covid 19 infection in a tertiary care hospital
Mandya Institute of Medical Sciences, Mandya district, Karnataka, India.
Methods: A retrospective study was carried out on maternal mortality during the COVID 19
pandemic in MIMS, Mandya, and Karnataka. We collected records of MMR due to covid 19
occurred from the month of June 2020 to July 2021 over a period of one year.
Results: MMR from June 2020 to July 2021 is 0.034/lakh live births, majority were of the
age group 25 to 35 yrs., majority of the death occurred after 5 days from tested positive, all
belonged to moderate or severe category of covid 19 infection. Termination of pregnancy was
done in 7 cases i/v/o worsening symptoms, 2 were antenatal deaths, 2 post abortal, 5 deaths
were in postoperative period. Most cases were managed on oxygen initially, on Noninvasive
ventilation (NIV) and later on intubated. All cases were treated with Thromboprophylaxis,
nebulization, steroids, IV antibiotics and Remdesivir was given in four cases.
Conclusion: Maternal mortality was more during second wave of pandemic. Maternal
mortality was more among moderate and severe disease and nil among mild cases.
Unpreparedness among healthcare workers in managing severe cases was among the key
determining factors. Better team approach by physicians, intensivists, Obstetricians and
infrastructure might be helpful in preventing maternal mortality. Covid vaccination among
pregnant women and providing essential drugs and anticipation of worsening symptoms and
early intervention might be beneficial in preventing future mortality.

A clinical analysis of ectopic pregnancies at tertiary health care hospital

Preetha F Nayakar, Ashwini Veeresh, Ambika HE, Prashanth S, Manjula B

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 999-1004

Background: Ectopic pregnancy (EP) is one of the life-intimidating emergencies in pregnancy leading to maternal morbidity and mortality. Early diagnosis of ectopic pregnancy presents a challenging problem and is considered an emergency as it shows high mortality risk and it’s early detection and management are necessary to prevent maternal mortality and morbidity.
Aim and Objectives: To evaluate the cases of ectopic pregnancy at a tertiary health care center and to determine the incidence, risk factors, clinical presentation, management, and morbidity associated with ectopic pregnancy.
Methodology: We conducted a prospective study on 37 patients with ectopic pregnancies at Shivamogga Institute of Medical Sciences a tertiary care center from August 2020 to August 2021. The primary outcome measures studied were the incidence of ectopic pregnancy, their risk factors, mortality and morbidity in those pregnant women.
Results and Discussion: The incidence of ectopic pregnancy in this study is 0.49%. The common age and parity affected were 26-30 years (59%) and para 1 (46%). The most common risk factors were previous LSCS (49%) followed by abdominal tubectomy, laparoscopic tubectomy and recanalization. The ampulla region (59.5%) was the most common site of ectopic pregnancy. Majority of cases presented with a ruptured ectopic (70.27%) and unruptured accounted for -29.72%. In our study Salpingectomy (78.37%) was the common surgical procedure performed. Around 83.77% of women received a blood transfusion. No maternal mortality occurred during this period due to ectopic pregnancy.
Conclusion: Ectopic pregnancy is a life-threatening condition occurring in women. Worldwide the incidence of ectopic pregnancy is increasing, which will increase maternal morbidity, mortality, and fertility. Early diagnosis and management will reduce the risk of maternal morbidity and mortality due to ectopic pregnancy.

A prospective study of factors affecting maternal and perinatal outcome in eclampsia at government medical college/hospital Nizamabad

Dr Neelima Singh, Dr.Mounika, Dr Badhe Rekha, Dr.N.Sreedevi, Nidhi Singh, Dr Tharani Badikela

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5124-5135

Introduction: Eclampsia is one of the commonest causes of maternal deaths. The
various factors influencing maternal and perinatal outcome were evaluated in the
present study.
Aim: To determine the factors affecting maternal and perinatal outcomein Eclampsia.
Materials and methods: Present study is a prospective observational study of factors
affecting maternal and perinatal outcome in Eclampsia for a period of 6 months.
Results: The incidence of eclampsia in 1.42%. Hypertension, oedema and proteinuria
are important signs in eclampsia. The incidence of maternal mortality in the present
study was 4% and the common causes of death were acute renal failure and pulmonary
oedema. The maternal mortality in correlation with age, parity, blood pressure,
duration of labour is not statistical significant. The perinatal mortality in the present
study was 24% and corrected perinatal mortality, excluding cases of absent FHS at
admission was 18%. Prematurity was the most important cause of neonatal deaths.
Perinatal mortality was maximum in unbooked cases (37%) and is statistically
significant. Perinatal mortality was maximum, when the number of convulsions were
maximum that is in between 6-10 (100%) and it is statistically highly significant.
Conclusions: Prompt control of convulsions and blood pressure along with steps to
initiate delivery are the cornerstone and critical in Management of eclampsia.

An Exploratory Qualitative Study of Sociocultural determinants of maternal health care services in Ethiopia

Ibsa Mussa Abdulahi

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1026-1048

Background: The high rate of maternal mortality reported in The Ethiopia is due to complications of pregnancy and delivery. In Ethiopia, the maternal mortality ratio had been 353/100,000 live births in 2015. The socio-cultural contexts under which these pregnancies and deliveries occur are the factors that pave the way for these complications and mortality. Therefore, this study was conducted to examine, and describe the sociocultural determinants of maternal health care in Ethiopia. Methods: This study was based on a qualitative, exploratory research design and used focus group discussions and in-depth interviews as its primary data collection techniques. Focus group discussions and in-depth interviews conducted in three districts (Haramaya, Grawa and Meta) in the Ethiopia. The study population consisted of 24 focus group discussants and 152 respondents homogeneous group. The data resulting from the discussion was transcribed verbatim and investigated using a qualitative thematic analysis based on ATLAS.ti.8.2.

MISSED OPPORTUNITY FOR MATERNAL HEALTH CARE SERVICES IN EASTERN ETHIOPIA

Ibsa Mussa Abdulahi Ibsa Mussa Abdulahi

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4713-4733

Background: In developing countries, a large number of maternal deaths happen due to complications of pregnancy and delivery. In Ethiopia, the maternal mortality ratio had been 353/100,000 live births in 2015. Therefore, this study was conducted to assess the missed opportunity for maternal health care services in Eastern Ethiopia.
Methods: A community-based cross-sectional study involving pregnant women in their third trimester and women who gave birth in the last five years was conducted between September to December 2017. Structured questionnaire was used for data collection and data were collected from a sample of 422 subjects in the districts. Descriptive (Univariable), bivariable and multivariable logistic regression analyses were conducted. Statistical tests were done at a level of significance of p < 0.05.
Results: The result of this study showed that among  359 (85%)  pregnant women who planned for  ANC visit,  16 (4.5%) received ANC four or more times during their last pregnancies, the respondents (81.3%) claimed that they were taken care of by skilled delivery attendant during delivery, 18.5% of them said that they delivered at home and 71.1% of them received medical care after delivery. Women in the age group 15-24 years (AOR=??95% CI: 0.37, 3.74) and women who intended their last pregnancy (AOR=??95% CI: 0.11, 0.94) were significant predictors of unplanned home delivery.  
Conclusion: For optimal and effective interventions of maternal health services utilization, provisions should be made for better women’s education, family planning, job opportunity, and women empowerment; provisions should also be made for creating income-generating activities for women. Strengthening village women’s army wing, refreshing and enabling health extension workers and traditional birth attendants. What is more, optimal measures should be taken to discourage traditional practices such as female genital mutilation, polygamy, violence against women, and teenage marriage. Finally, free maternal and child health services should be advocated for so that the gap in maternal healthcare services is bridged.