Maternal mortality, descriptive study in ninava city | ||
| Medical Journal of Tikrit | ||
| Article 1, Volume 1, Issue 181, December 2012, Pages 133-140 | ||
| Authors | ||
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| Abstract | ||
| More than 500,000 women died from complications related to pregnancy or childbirth in 2000 in developing countries, but 99% of those maternal deaths were preventable . The aim of this paper was to analysis MMR in Nineveh city in the year 2007. Data concerning maternal deaths collected from the reports issued by Committee of Confidential Inquiry for Maternal Deaths were analyzed regarding the maternal age ,parity , direct and indirect causes of deaths , rate of deaths in side and out side hospital, level of care available at delivery, distance women need to arrive to health facilities, mode of transport. 43 maternal deaths among 95526 deliveries during the study period . MMR was estimated to be 45/100000 live births. The age range was between 20-42years there were 22(84.8%) cases >30,most of them(44.9% ) were grand multiparous (parity >5). ). Direct causes of maternal deaths were accounting 36cases(83.7%) of deaths, indirect causes were present in four cases ( 9.3%). Unknown causes found in three cases. The leading direct causes of maternal deaths were hemorrhage twenty four cases (55.8%) ,Hypertension nine (20.5%) ,pulmonary embolism three (6.9%). 21/24(75%) died from hemorrhage out side hospital after home births and three cases (6.9%) from ante partum haemorrhage in side hospital . The level of care available at delivery was estimated, 40% attended by traditional birth attendants(TBA), 33% by lady health visitors, 10% by doctors and to 17% no level of care was available. The distance women needed to arrive to the hospital was between 10 and 100 KM. Majority of the cases (sixteen )transported by private car. Hypertension complicated pregnancy is the second direct cause of death . Nine cases (20.6%) died from hypertension complication .Six cases (66.6%) in side health institute from cerebrrevascualr accident ,pulmonary oedema ,coagulation failure. Three cases(33.6%) out side health institute before delivery from eclamptic fits. The present study conclude that, although registrations of maternal deaths is improved in our locality, still the direct avoidable causes of maternal deaths ( haemorrhage , hypertension, pulmonary embolism ) are the major causes of deaths. Also, the present study recommend that, strong policies to reduces these causes were needed in term of activation of basic emergency obstetrics care. There must strategies to reduce avoidable causes by: First, by ensuring availability of health professionals trained and experienced in obstetric complications may significantly reduced maternal mortality. Second by, traditional birth attendant should be trained not to cause complications, rather recognize complications and not to manage complications on their own and should be motivated to make referrals. Third by, existing health services should be improved and emergency obstetrical care should be available to all women round the clock. Equipping the existing basic health units and rural health centres with Basic emergency obstetric care (BEOC) includes: injectable antibiotics, anticonvulsants and oxytocics Misoprostole , O negative blood products. And the fourth by, repeated and closely spaced pregnancies should be discouraged and contraceptive prevalence needs to be increased in culturally conservative areas. | ||
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