Maternal mortality and near miss situations

Maternal mortality and near miss situations by Dr Sangeeta Gupta on 4/10/18

Kerala lowest maternal mortality 46/100000
Maternal death – death during or within 42 days of termination of pregnancy due to causes directly or aggravated by pregnancy 
MMR -130/100000 SRS data 2014-16
Seven states reached MDG of less than 100/100000 maternal death 
MMR 12/100000 in developed countries —- lowest 3/100000 in Iceland 
SDG – sustainable development goal by 2030 is MMR is 70/100000 and no country should have double the rate of SDG 
A women’s lifetime risk of dying due to maternal death at 15 years is 1 in 4900 in developed countries and 1 in 180 in developing countries 
Three delays of MMR
  1. Delay in deciding conditions 
  2. Delay in transport 
  3. Delay in administering due care
MMR even in institutional deliveries 60-70/100000…. healthcare need to improve 
How to improve MMR
Obstetric HDU and ICU must in all government hospital 
Maternal health improvement by healthy diet and supplements 
Motherhood by choice- effective contraception 
Maternal death audit
Prevent PPH
  • Oxytocin and misoprost should be available 
  • Chhattisgarh balloon tamponade
Prevent sepsis aseptic technique and availability of antibiotics 
Treat anaemia and PIH
Near miss situations 
Woman survived a near maternal death 
-Disease specific – severe anaemia, severe PIH
-Admission to ICU- PPH, medical disorders 
-organ dysfunction specific- cardiac causes etc
Indian government 
Near miss situations are simple to analyse and easier to resolve and causes of near miss and maternal deaths are same.
Dr. Sharda Jain
Dr Meenakshi Sharma
HQ: 11 Gagan Vihar Near Karkari Morh
Flyover Delhi 51
(M) 9650511339, 8826638849

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