EMERGENCY OBSTETRIC CARE - AN INTERVENTION OF MATERNAL MORTALITY

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EMERGENCY OBSTETRIC CARE - AN INTERVENTION OF MATERNAL MORTALITY

  1. 1. WELCOME
  2. 2. EMERGENCY OBSTETRIC CARE AN INTERVENTION OF MATERNAL MORTALITY Presented by CAPT SHAMS ROSTER 56 OBC 77
  3. 3. INTRODUCTION Maternal deaths and disabilities are leading contributors in women's disease burden with an estimated 275,000 women killed each year in childbirth and pregnancy worldwide. In 2011, there were approximately 273,500 maternal deaths (uncertainty range, 256,300 to 291,700). Forty-five percent of postpartum deaths occur within 24 hours. Over 90% of maternal deaths occur in developing countries.
  4. 4. AIM
  5. 5. PICTURE OF BANGLADESH Bangladesh has a high maternal mortality ratio, with 320 deaths per 100,000 births. This means there are about 11,000 to 12,000 women dying from pregnancy or childbirth complications every year in Bangladesh These high mortality rates are underpinned by the fact that nine out of every 10 deliveries take place at home, most with unskilled attendants or relatives assisting.
  6. 6. MATERNAL MORTALITY Death of a women while pregnant or within 42 days of termination of pregnancy from any cause related to or aggravated by the pregnancy but not from accidental or incidental cause.
  7. 7. Maternal mortality Direct Cause Indirect Cause
  8. 8. Direct Causes 1) Haemorrhage (25%). 2) Infections (13%). 3) Unsafe abortion (13%). 4) Eclampsia (12%). 5) Obstructed labour (8%). 6) Other direct causes (8%).
  9. 9. Indirect Causes 1) Cardiovascular disease aggravated by pregnancy/delivery. 2) Respiratory disease aggravated by pregnancy/delivery. 3) Anaemia.
  10. 10. Underlying Factors 1) Social issues 2) Economic Issues 3) Medical issues
  11. 11. Social issues (1) Early marriage (2) Gender discrimination (3) Illiteracy (4) Desire for selective sex of child- female feticide (5) Domestic violence
  12. 12. Economic Issues 1) Lack of money 2) Lack of timely transport and communication 3) Delay in taking decision to shift 4) Improper dietary habits
  13. 13. Medical issues 1) Lack of ANC 2) Lack of emergency obstetric care 3) Lack of blood and blood products 4) Lack of essential drugs 5) Junior staff dealing with high risk cases without supervision 6) Delay in diagnosis / wrong diagnosis
  14. 14. Three Delay Model 1. Delay in seeking appropriate medical help for an obstetric emergency for- a) Reasons of cost, b) Lack of recognition of an emergency, c) Poor education, lack of access to information and gender inequality.
  15. 15. 2. Delay in reaching an appropriate facility for reasons of distance, Under developed transportation and Medical & Health infrastructure.
  16. 16. 3. Delay in receiving adequate care when a facility is reached, because there are- a) Shortages in staff / electricity and water. b) Medical supplies are not available/ inadequate
  17. 17. WHAT SHOULD WE DO? Lets have a look…
  18. 18. Interventions to Reduce Maternal Mortality Historical review 1) Traditional birth attendants 2) Antenatal care 3) Risk screening
  19. 19. Current approach 1) Skilled provider at childbirth 2) Emergency Obstetric Care (EmOC)
  20. 20. Emergency Obstetric Care (EmOC) EmOC or emergency obstetric care refers to the functions necessary to save lives. They are called Signal Functions.
  21. 21. 1) Administer parenteral antibiotics 3) Administer parenteral anticonvulsants for pre-eclampsia and eclampsia 4) Perform manual removal of placenta 2) Administer parenteral oxytocic drugs
  22. 22. 7) Perform surgery 8) Perform blood transfusions 6) Perform assisted vaginal delivery 5) Perform removal of retained products
  23. 23. EmOC Process Indicators In general, process indicators show you the changes in the conditions that lead to an outcome (such as death or disability)
  24. 24. INDICATOR #1 1 Comprehensive EmOC Facility 4 Basic EmOC Facilities For every 500,000 population, there should be at least:
  25. 25. INDICATOR #2 EmOC Facilities should be well distributed to serve 500,000 people Geographical Distribution of EmOC Facilities
  26. 26. INDICATOR #3 At Least 15% of All Births in the Community Should Take Place in EmOC Facilities Proportion of All Births in EmOC Facilities
  27. 27. INDICATOR #4 Met Need for EmOC Services At Least 100% of Women Estimated to Have Obstetric Complications Should Be Treated in EmOC Facilitiesd
  28. 28. INDICATOR #5 Cesarean Sections as a Percentage of All Births Minimum: 5% Maximum: 15%
  29. 29. INDICATOR #6 Case Fatality Rate Proportion of Women with Obstetric Complications Admitted to a Facility Who Die: Maximum Acceptable Level 1%
  30. 30. Available and Accessible on Time Any Country Can Avert Maternal Death and Disability if it Makes Good EmOC
  31. 31. Study in Matlab
  32. 32. Recommendations 1) EmOC care should be available in root level. 2) Increase awareness among the people. 3) Health care provider should be skillful. 4) Proper risk screening.
  33. 33. CONCLUSION
  34. 34. Thank You

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