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.”
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