Maternal death, MD

Notes
  • The World Health Organization (WHO) defines Maternal death as "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes”
  • Statistics: Daily Maternal mortality due to preventable pregnancy-related causes -830 deaths (99% of which are in developing countries); annual Maternal mortality due to preventable pregnancy-related causes -275,000 deaths; Maternal mortality ratio (MMR) in developing countries in 2015 – 239 while it was 12 in developed countries ; MMR in Kenya e.i. deaths per 100,000 live births - 510 as compared with Japan (4), Rwanda (320), Uganda (360) and Eritrea (380); Annual Maternal death; Mandera county had MMR of 3795 (2014); out of the total number of women of reproductive age who had died in Kenya in 2014, 21% was due to Maternal death; 45% of postpartum deaths occur within 24 hours after delivery.
  • A target under Sustainable Development Goal 3 (SDG 3) is to reduce the global MMR to < 70, with no country having MMR of > twice the global average.

##Major complications are responsible for MD are:

  • Postpartum (puerperal) hemorrhage (15%)
  • Unsafe abortion (15%)
  • Postpartum (puerperal) infections (8%)
  • Pre-eclampsia and eclampsia (10%)
  • Pre-existing conditions such as malaria, AIDS and cardiovascular diseases (28%)
  • Blood clots (3%)
  • Pulmonary embolism
  • Complications from delivery
  • Adolescents aged 15 years or younger have higher risks of delivery complications such as:

_Episiotomy

_Low birth weight

_Operative vaginal delivery

_Preterm delivery

_Puerperal endometritis

_Puerperal hemorrhage

_Small-for-gestational-age infants

 (Each complication is discussed as a substantial stand-alone topic in this publication)

Symptoms
  • Not applicable
Diagnosis
  • Not applicable
Differential
  • Not applicable
Prevention
  • Increase access to antenatal care in pregnancy (≥ 4 visits)
  • Skilled care during childbirth
  • Skilled care and support in the weeks after childbirth.
  • Establishment of emergency obstetric care to address the major causes of maternal death
  • Poverty reduction
  • Education of women and communities
  • Improvement of infrastructure
Management
  • Not applicable
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