![Note:
The appropriate denominator for the
maternal mortality ratio would be the total
numbers of pregnancies [live births, fetal
deaths (stillbirths), induced and
spontaneous abortions, ectopic and molar
pregnancies ].However, this figure is
seldom available, either in developing
countries where most births take place or
in developed countries, and so the number
of live births is generally used as the
denominator.](https://image.slidesharecdn.com/jssmc-pg-maternalmortalitycauses-230529152211-9828379f/85/MATERNAL-MORTALITY-CAUSES-ppt-7-320.jpg)
MATERNAL MORTALITY CAUSES.ppt
- 2. WHAT IS MATERNAL DEATH? ‘‘The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.”
- 3. TYPES According to ICD : 1. DIRECT OBSTETRIC DEATHS 2. INDIRECT OBSTETRIC DEATHS
- 4. DIRECT OBSTETRIC DEATHS These result from 5 major causes 1. Haemorrhage esp. PPH 2. Sepsis 3. Eclampsia 4. Obstructed labour 5. Unsafe abortions.
- 5. INDIRECT OBSTETRIC DEATHS Results from previously existing diseases or from diseases arising during pregnancy which are aggravated by the physiological effects of pregnancy. E.g.: Malaria, Anaemia, HIV/AIDS, Cardiovascular disorders, Diseases of Endocrine & metabolic systems.
- 6. Measures of Maternal Mortality 1. MATERNAL MORTALITY RATIO Represents the risk associated with each pregnancy i.e, the obstretic risk. It is calculated as the no. of maternal deaths during a given year per 1 lakh live births during the same period. Although the measure has traditionally been referred to as a rate it is actually a ratio.
- 7. Note: The appropriate denominator for the maternal mortality ratio would be the total numbers of pregnancies [live births, fetal deaths (stillbirths), induced and spontaneous abortions, ectopic and molar pregnancies ].However, this figure is seldom available, either in developing countries where most births take place or in developed countries, and so the number of live births is generally used as the denominator.
- 8. 2.Maternal Mortality Rate Measures both the obstretic risk & the frequency with which women are exposed to this risk. It is calculated as the no. of maternal deaths in a given period per 1 lakh women reproductive age (usually 15 to 49 years). The terms “ratio” and “rate” are often used interchangeably; for the sake of clarity it is therefore essential, when referring to either of these measures of maternal mortality, to specify the denominator used.
- 9. 3. Life Time Risk Of Maternal Death Takes into account both the probability of becoming pregnant & the probability of dying as a result of the pregnancy cumulated across a woman’s reproductive years.
- 10. The lifetime chances of maternal death in the world is about 1 in 75. In the least developed countries 1 in16. In the developing countries 1 in 60. In the industrialized countries 1 in 4100. In Sub-Saharan region the chances are 1 in 13 pregnancies.
- 11. LATE MATERNAL DEATH :- “The death of a woman from direct or indirect obstetric causes more than 42 days but less than 1 year after termination of pregnancy.” PREGNANCY RELATED DEATH:- “The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of the death.”
- 12. INCIDENCE Global Scenario According to WHO estimates about 5,10,000 maternal deaths occurred globally in the year 2002. Of these 2,31,000 occurred in African countries 17,000 in America 68,000 in eastern Mediterranean 3,000 in European countries 1,71,000 in SEAR countries
- 13. NEIGHBOURING COUNTRIES SNo. NATION MMR 1 India 407 2 Afghan 820 3 Bangladesh 380 4 Nepal 740 5 Pakistan 500 6 Sri lanka 30 7 China 56 8 Myanmar 360 9 Thailand 44 DEVELOPED COUNTRIES SNo. NATION MMR 1 Greece 10 2 Finland 05 3 Canada 05 4 Australia 06 5 Sweden 08 6 Israel 13 7 U.K 11 8 Japan 10 9 Singapore 15
- 14. Source RGI RGI Bhat IIHW@ STATE 1997 1998 1994 1998-99 Punjab 196 199 289 351 Haryana 105 103 289 468 U.P 707 707 612 737 Rajasthan 677 670 588 526 Maharashtra 135 135 477 365 Gujarat 29 28 477 393 A.P 154 159 383 341 Tamil Nadu 76 79 383 284 INDIA 408 407 544 466
- 15. Socio economic variations in MMR Characteristics Sub categories MMR (per lakh) Caste SC 584 ST 652 Others 516 Religion Hindu 573 Muslim 384 Others 428 Education Illiterate 574 Literate 480 Socio economic status Poor 555 Middle 479 Non poor 484
- 16. Causes of Maternal Mortality Anaemia 19% Hemorrhage 29% Obstructed Labour 10% Abortion 9% Others 9% Toxaemia 8% Sepsis 16%
- 17. Determinants of maternal mortality • Medical Factors • Social Factors • Obstetric • Non Obstetric
- 18. Obstetric Causes Haemorrhage Infection Obstructed labour Unsafe Abortion Hypertensive disorders of Pregnancy
- 19. Non obstetric causes Anaemia Associated diseases Malignancy Accidents
- 20. Social Factors Women’s age Birth spacing Parity Malnutrition Environmental conditions Lack of adequate services Others.
- 21. “Regarding maternal deaths, we know the causes. We have the solutions for most cases. We have begun to make a difference.”
- 22. Thank you