A small ppt regarding some vital statistics in Obstetrics

1. VITAL STATISTICS
PART -1
ROLL NO 2
ABHILASHATHAKUR

2. EPIDEMIOLOGY OF OBSTETRICS
Sensitive quality of the health care delivery system of a country as whole or in part —-
re
fl
ected by maternal and perinatal mortality rates .
India’s hold in world population — 16% , India’s hold in world’s maternal deaths — 20%

3. FACTORS RESPONSIBLE
Unregulated fertility
Unsafe abortion
Inadequate antenatal care
Lack of trained birth attendants

5. MATERNAL MORTALITY
MATERNAL DEATHS -death of a woman while pregnant or within 42 days of termination
of pregnancy irrespective of duration and site of pregnancy ,from any cause related to or
aggravated by pregnancy or it’s management BUT NOT from accidental or incidental causes
MATERNAL MORTALITY RATIO -expressed in terms of such maternal deaths per 100,000
live births
In developed countries 4-40
In developing countries 100-700 , INDIA -254

7. MATERNAL MORTALITY RATE
Number of maternal deaths divided by the number of women of reproductive age (15-49)
It is expressed per 100,000 women of reproductive age per year .
In India -120 , as compared to U.S. - 0.5
Currently,reproductive mortality-maternal mortality and mortality from the use of
contraceptives

8. MAGNITUDE OFTHE PROBLEM
Worldwide ,every year approx 8 MILLION women suffer from pregnancy related
complications ,over half a million die as a result .
One woman in 11 may die of pregnancy related complications in developing
countries ,compared to 1 in 5000 in developed countries.

9. CLASSIFICATIONS
DiRECT OBSTETRIC DEATH -resulting from complications of pregnancy ,delivery or
management. Example - ectopic pregnancy
INDIRECT- conditions present before or developed during pregnancy but aggravated by the
physiological effects of pregnancy and strain of labor. Example anemia
NON -OBSTETRIC DEATHS-Accidents

10. FACTORS ASSOCIATED WITH MATERNAL
MORTALITY
AGE-In women above 35 years of age risks are 3-4 higher for pre eclampsia ,uterine inertia
PARITY- In multigravida risks are 3 times higher for postpartum hemorrhage ,ruptured
uterus
SOCIOECONOMIC STRATA - Mortality ratios are higher in poor women
SUBSTANDARD CARE - When care is provided below the generally acceptable
level ,available at those circumstances

12. ACTIONS FOR SAFE MOTHERHOOD
HEALTH SECTOR ACTIONS -
Basic antenatal , intramural and postnatal care
Functioning referral system
Emergency obstetric care (EmOC)
Good quality obstetric services
Family planning services
Frequent joint consultation

13. COMMUNITY ,FAMILY AND SOCIETY ACTIONS
POLICY MAKERS’ ACTIONS
To organise community education, motivation and formation of safe motherhood
committee at local level
To strengthen the referral system for obstetric emergencies
To develop written management protocols for obstetric emergencies in hospitals
To improve standard and quality of care by organising refresher courses for the healthcare
personnel

14. LEGISLATIVE AND POLICY ACTIONS
Girl children and adolescents should have good nutrition ,education and economic
opportunities
Barriers to the access of healthcare facilities should be removed
Decentralisation of services to make them available to all women
National policies for safe abortion and post abortion care
Social inequalities on ground levels must be removed

15. MATERNAL NEAR MISS
Severe Acute Maternal Morbidity (SAMM)
A woman who nearly died but survived a complication that occurred during
pregnancy ,childbirth or within 42 days of termination of pregnancy
MNM Ratio -number of MNM per 1000 live births
Diseases or complications causing MNM - eclampsia ,renal failure ,DIC

16. MATERNAL /OBSTETRIC MORBIDITY
Originates from any cause related to pregnancy or it’s management anytime during
antepartum intrapartum or postpartum period up to 42 days of con
fi
nement
Parameters - Fever >38 degree ,blood pressure >140/90 mm of hg ,recurrent vaginal
bleeding ,Hb %<10.5g ,asymptomatic bacteruria of pregnancy
May be direct -TEMPORARY -sepsis , ectopic pregnancy PERMANENT- infertility
Indirect -tuberculosis,anaemia

17. THANKYOU