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Maternal deaths

LLEWELLYN-JONES D

Med J Malaya, 1958 Sep;13(1):103-8.
PMID: 13589379
Matched MeSH terms: Maternal Death*
The prevention of maternal death

LLEWELLYN-JONES D

Med J Malaya, 1957 Jun;11(4):291-9.
PMID: 13482565
Matched MeSH terms: Maternal Death*
Fulltext Evaluation of the service provision of emergency obstetric care in a tertiary care centre: a clinical audit

Francis Paul, Kent Kong Kian Keong, Jennifer Tan, Anna Lee En Moi, Alen Lim Chung Chieh

Borneo Journal of Medical Sciences, 2020;3(101):5-6.
MyJurnal

Introduction: Maternal death is a sensitive health indicator being monitored closely by the Ministry of Health. Obstetric emergency (OE) protocol is introduced to manage OE and to improve maternal outcome. However, there is no national OE guideline available and the OE protocol varies among different institutions. The current audit aims to evaluate the service quality during OE in Duchess of Kent Hospital (DOKH) in accordance with OE protocol DOKH revision-2017.

Matched MeSH terms: Maternal Death
Fulltext Acute appendicitis in pregnancy: a diagnostic and management challenge

Zainur Rashid, Z., Sulaiha, S.A., Azmi, M.N.

International Medical Journal Malaysia, 2014;13(1):77-80.
MyJurnal

Acute appendicitis is the most common extra-uterine surgical emergency encountered during pregnancy, but an accurate diagnosis is still an enigma. Anatomical shifting of the appendix by the enlarging uterus makes the clinical and sonographic diagnosis difficult. Prompt diagnosis and treatment are essential to prevent perforation, which increases the risk of fetal and maternal death. Surgical intervention, either by an open laparotomy or laparoscopy is the most appropriate treatment for appendicitis. This article reviews the epidemiology, clinical diagnosis, investigation, complications and treatment of acute appendicitis in pregnancy.

Matched MeSH terms: Maternal Death
Fulltext Male participation and sharing of responsibility in strengthening family planning activities in Malaysia

Rosliza, A.M., Majdah, M.

Malaysian Journal of Public Health Medicine, 2010;10(1):23-27.
MyJurnal

Family planning is one of the main pillars of safe motherhood initiatives. It is therefore a very crucial area that needs continuous strengthening and improvement in order to reduce maternal morbidity and mortality which will ultimately improve the general condition of women. Findings from the Confidential Enquiries into Maternal Death (CEMD) Malaysia Report 2001 - 2005 revealed that up to 70% of the maternal deaths never practiced any form of family planning. The contraceptive prevalence rate (CPR) in Malaysia for the year 2004 was 51.7% compared to Thailand, Vietnam and Singapore which was 79%, 74% and 74% respectively. One neglected area that has never been emphasized seriously in the family planning programme in Malaysia is male participation, gender awareness and sharing of responsibility by both partners. In realizing this, efforts have been made to include men as target groups in the national family planning programme. This paper will highlight the importance of optimum gender relations and sharing of responsibility with special emphasis towards the role of husbands and male medical personnel in the effort to improve family planning activities. It will also discuss the efforts put by the Ministry of Health in order to create gender awareness and encourage male participation in family planning.

Matched MeSH terms: Maternal Death
Fulltext Measuring maternal mortality in Malaysia

Hematram, Y.

JUMMEC, 2006;9(1):30-34.
MyJurnal

There has been a significant decline in maternal mortality in Malaysia since independence. The issue of measuring maternal mortality accurately is a problem in all countries. Another major problem is whether we can reduce the mortality further. The definition of maternal mortality includes two major components, which are causation of death and the time of death. To improve data collection on maternal deaths, we need to collect all data on maternal deaths, which are omitted or misclassified. Deaths from accidental causes that are not normally used in the calculations of maternal mortality need to be carefully reexamined to be excluded. The time of death means that in maternal mortality calculations, it includes up to six weeks after delivery, but recent World Health Organization (WHO) publication (ICD-10) suggests that the collection of maternal deaths even after six weeks should be reviewed because there are many maternal deaths which occur after six weeks. Measuring maternal mortality rate should be encouraged rather than maternal mortality ratio. Another measurement of maternal mortality is the lifetime risk of the women. The lifetime risk is the measure of maternal mortality that takes into account the probability of becoming pregnant and the probability of dying as a result of pregnancy. Many countries have started reporting the lifetime risk, which is considered to be better indicator to measure maternal health.

Matched MeSH terms: Maternal Death
Fulltext Determinants of healthcare facility utilization for childbirth in Kuantan Singingi regency, Riau province, Indonesia 2017

Sukirman R, Wahyono TYM, Shivalli S

BMC Public Health, 2020 Jun 15;20(1):933.
PMID: 32539758 DOI: 10.1186/s12889-020-09035-3

BACKGROUND: Reducing maternal mortality ratio (MMR) is a high priority public health issue in developing countries such as Indonesia. The current MMR in Indonesia is 126/100,000 live births. Optimum use of available healthcare facilities for delivery can avert maternal deaths. This study aimed to determine the factors associated with healthcare facility utilization for childbirth in Kuantan Singingi regency, Riau province, Indonesia 2017.
METHODS: We conducted a community-based cross-sectional study in 15 sub-districts of Kuantan Singingi regency from May-June 2017. We selected 320 mothers from 15 sub-districts who delivered in the last 3 months (February-April 2017). Trained data enumerators collected the relevant data by using a pre-tested semi-structured questionnaire. We used Cox regression analysis to determine the factors associated with delivery at healthcare facilities. Prevalence Ratio (PR) with a 95% confidence interval (CI) for childbirth at healthcare facilities was the key outcome measure.
RESULTS: Only 54.4% (174) of the 320 mothers delivered at healthcare facilities. Knowledge about pregnancy danger signs (PR = 1.59, 95%CI:1.15-2.2), attitude towards healthcare services (PR = 0.79, 95%CI:0.33-1.89), and access to health care services (PR = 0.39, 95%CI:0.18-0.84) were the dominant factors of childbirth at healthcare facilities. There was an interaction between attitude and access to healthcare influencing delivery at healthcare facilities.
CONCLUSIONS: Utilization of healthcare facilities for childbirth was low in Kuantan Singingi regency. Knowledge of pregnancy danger signs was an independent correlate of childbirth at healthcare facilities. Also, the interaction between attitude and access to healthcare showed a significant influence on childbirth at healthcare facilities. We recommend strengthening of existing maternal and child health program with a particular emphasis on complete and quality antenatal care, health education on danger signs of pregnancy and childbirth, and promoting positive attitudes towards healthcare facilities.

Matched MeSH terms: Maternal Death/prevention & control
Adverse pregnancy outcomes among multi-ethnic systemic lupus erythematosus patients in Malaysia

Shaharir SS, Maulana SA, Shahril NS, Mohd R, Mustafar R, Said MSM, et al.

Lupus, 2020 Sep;29(10):1305-1313.
PMID: 32660312 DOI: 10.1177/0961203320938871

BACKGROUND: Despite the improvement in the live birth rate among patients with systemic lupus erythematosus (SLE), they are still at an increased risk of adverse pregnancy outcomes (APOs).
OBJECTIVE: To determine the prevalence and factors associated with APOs in the multi-ethnic SLE populations in Malaysia.Methodology: This was a retrospective review of the consecutive SLE patients who attended the outpatient clinic in two major rheumatology centres from January 2016 until December 2019 with complete pre-pregnancy, antenatal and intra-partum records. APOs include pregnancy loss, prematurity, pre-eclampsia, intra-uterine growth restriction (IUGR) and maternal death. Univariate and multivariable logistic regression with generalised estimating equation (GEE) analyses were performed to determine the factors associated with APOs.
RESULTS: A total of 153 patients with 240 pregnancies were included and the majority of the patients were Malay (69.9%), followed by Chinese (24.2%) and Indian (5.9%). The prevalence of APOs was 61.7% with the commonest complication being prematurity (28.3%), followed by pregnancy loss (24.6%) and pre-eclampsia (21.8%). Logistic regression model-based GEE analysis revealed that the independent predictors of APOs were active haematological system during pregnancy, pre-pregnancy active disease, Indian patients and positive lupus anticoagulant. Hydroxychloroquine use was associated with lower APOs including pre-eclampsia, prematurity and IUGR in the univariate analyses but it was no longer significant in the GEE analysis.
CONCLUSION: The prevalence of APOs was high particularly among the Indian patients. Positive lupus anticoagulant and pre-pregnancy active disease were the factors strongly associated with APOs in our multi-ethnic cohort. Hydroxychloroquine may protect against APOs but further larger studies are needed to confirm this.

Matched MeSH terms: Maternal Death
Fulltext Effectiveness of free maternal healthcare programme under the successful delivery programme in jigawa state, Nigeria

Muhammad Abdulkadir, Ruslan Rainis, Alshammari Eissa Zaidan, Murtala Uba Muhammad, Yamuna A Kani

Malaysian Journal of Social Sciences and Humanities, 2019;4(7):140-151.
MyJurnal

In the state effort reduce the number of maternal death, a free child and maternal healthcare programme were introduced called Successful delivery. This main aim of this research is to evaluate if women registered with the programme had a better chance of accessing the services in the state. A crosssectional quantitative study involving household interviews of all women of the reproductive age group (15–49 years) residing in Jigawa state from February to April 2019. Logistic regression analysis at 95% confidence interval was used to determine the independent associations between the scheme and use of antenatal care, hospital delivery and postnatal care services. Successful delivery program influenced the antenatal care visit as women registered with the schemes are more likely to have maximum of six visit 39.5 times than those who did not and also more likely to have four visit 2.6 times than those without scheme. Hospital delivery is also attached to the scheme as women registered with the scheme is 5.3 times likely to deliver at hospital when compared to those with not. Successful delivery program influence antenatal care visit and hospital base delivery. Nevertheless many of the pregnant women after delivery did not attend postnatal care.

Matched MeSH terms: Maternal Death
Fulltext A review of maternal mortality in Malaysia

Yadav H

International e-Journal of Science, Medicine & Education, 2012;6(10):0-0.
MyJurnal

There has been a significant decline in maternal mortality from 540 per 100,000 live births
in I957 to 28 per 100,000 in 2010. This decline is due to several factors. Firstly the introduction of the rural health infrastructure which is mainly constructing health centres and midwife clinics for the rural population. This provided the accessibility and availability of primary health care and specially, antenatal care for the women. This also helped to increase the antenatal coverage for the women to 98% in 2010 and it increased the average number of antenatal visits per women from6 in 1980 to 12 visits in 2010 for pregnant women. Along with the introduction of health centres, another main feature was the introduction of specific programmes to address the needs of the women and children. In the 1950s the introduction of Maternal and Child Health (MCH) programme was an important
step. Later in the late 1970s there was the introduction of the High Risk Approach in MCH care and Safe Motherhood in the 1980s. In 1990, an important step was the introduction of the Confidential Enquiry into Maternal Deaths (CEMD). Another significant factor in the reduction is the identification of high risk mothers and this is being done by the introduction of the colour coding system in the health centres. Other factors include the increase in the number of safe deliveries by skilled personnel and the reduction in the number of deliveries by the Traditional Birth Attendants (TBAs). The reduction in fertility rate from 6.3 in 1960 to 3.3 in 2010 has been another important factor. To achieve the 2015 Millennium Development Goals (MDG) to further reduce maternal deaths by 50%, more needs to be done especially to identify maternal deaths that are missed by omission or misclassification and also to capture the late maternal deaths.

Matched MeSH terms: Maternal Death
Fulltext Teenage pregnancy and its health implications

Hayward G

Int J Public Health Res, 2011;1(2):100-102.
MyJurnal

The World Health Organisation (WHO, 2006) defines teenage pregnancy as a 'teenaged or underaged girl (usually within the ages of 13-19) becoming pregnant.' The term usually refers to women who become pregnant, who have not reached legal adulthood; legal adulthood varies in different countries. The term teenage pregnancy is widely used however, to mean unmarried adolescent girls who become pregnant. Pregnant teenagers face many additional obstetric, medical & social issues compared to women who give birth in their 20s and 30s. Most at risk are mothers under fifteen and those living in developing countries. Complications during pregnancy and delivery are the leading causes of death for girls aged 15 to 19 in developing countries; they are twice as likely to die in childbirth as women in their twenties, with adolescents accounting for 13% maternal deaths worldwide. There is evidence to show (UNICEF Malaysia, 2008) that teenage pregnancy is associated with lower educational levels, higher rates of poverty and that the situation is often repeated with children of teenage parents. In addition, teenage pregnancy is often outside of marriage and therefore carries a social stigma in many cultures and community.

Matched MeSH terms: Maternal Death
Fulltext Islamic perspectives of reproductive and maternal health: what role can nigerian muslim religious leaders play in the prevention of maternal mortality? –with particular reference to Zamfara State Northwest Nigeria

Maiwada, Abdullahi Mohammed, Nik Mazlan Mamat, Nor Azlina A. Rahman, Suzanah Abdul Rahman, Baba, Tukur Mohammed

International Medical Journal Malaysia, 2018;17(101):7-14.
MyJurnal

Reproductive and Maternal health are an important components of public health and medicine which are concerned with the complete state of physical, mental and social wellbeing in all matters regarding reproductive system and health of mother especially during pregnancy.It implies ensuring that all women receive the care they need to be safe and healthy throughout pregnancy, childbirth and beyond. However, according to World Health Organization, millions of women all over the world do not have access to good quality health services during pregnancy and childbirth resulting in mortalities. Islam is a complete way of life. The Qur’an and Hadith consider pregnancy and child bearing as signs among other signs of the divine existence of Allah.The importance of maternal and reproductive is thus not unexplained in the Islamic perspectives. The study look at what role Muslim religious leaders can play in the prevention of maternal deaths and morbidities in developing countries. A qualitative study was conducted through in-depth interviews and focus groups discussion with a purposive sample of some Muslim religious leaders from Gusau local government area of Zamfara state northwest Nigeria in order to elicit information about the Islamic perspectives of reproductive and maternal health and the roles they can play in the prevention of maternal deaths among the Muslim communities. Muslim Religious leaders have a crucial role and contribution for the attainment and maintenance of good heath of women and children among Muslim communities through public enlightenment in the context of ‘ilm’, providing guidance through ‘Fatwah’ and community mobilization in the spirit brotherhood ‘ukhuwah’.Islam does not accept the “preventable death of a woman” due to childbirth or pregnancy. Thus, Islam encourages attendance of antenatal care visits and health care seeking.

Matched MeSH terms: Maternal Death
Socio-economic and environmental factors influenced the United Nations healthcare sustainable agenda: evidence from a panel of selected Asian and African countries

Saleem H, Jiandong W, Aldakhil AM, Nassani AA, Abro MMQ, Zaman K, et al.

Environ Sci Pollut Res Int, 2019 May;26(14):14435-14460.
PMID: 30868457 DOI: 10.1007/s11356-019-04692-3

The objective of the study is to evaluate socio-economic and environmental factors that influenced the United Nations healthcare sustainable agenda in a panel of 21 Asian and African countries. The results show that changes in price level (0.0062, p death (4.579, p death and under-5 mortality rate, (ii) from depth of food deficit to incidence of tuberculosis and unemployment, (iii) from PM2.5 emissions to infant mortality rate, (iv) from foreign direct investment (FDI) inflows to PM2.5 emissions, (v) from trade openness to greenhouse gas (GHG) emissions, and (vi) from mortality indicators to per capita income, while there is a feedback relationship between health expenditures and per capita income across countries. The variance decomposition analysis shows that (i) under-5 mortality rate will increase out-of-pocket health expenditures, (ii) unemployment rate will increase mortality indicators, and (iii) health expenditures will increase economic well-being in a panel of selected countries, for the next 10 years.

Matched MeSH terms: Maternal Death
The Role of Public Health Nutrition in Achieving the Sustainable Development Goals in the Asia Pacific Region

Binns C, Lee MK, Low WY, Zerfas A

Asia Pac J Public Health, 2017 Oct;29(7):617-624.
PMID: 29094630 DOI: 10.1177/1010539517736441

The Sustainable Development Goals (SDGs) replaced the Millennium Development Goals (MDCs) in 2015, which included several goals and targets primarily related to nutrition: to eradicate extreme poverty and hunger and to reduce child mortality and improve maternal health. In the Asia-Pacific Academic Consortium for Public Health (APACPH) member countries as a group, infant and child mortality were reduced by more than 65% between 1990 and 2015, achieving the MDG target of two-thirds reduction, although these goals were not achieved by several smaller countries. The SDGs are broader in focus than the MDGs, but include several goals that relate directly to nutrition: 2 (zero hunger-food), 3 (good health and well-being-healthy life), and 12 (responsible consumption and production-sustainability). Other SDGs that are closely related to nutrition are 4 and 5 (quality education and equality in gender-education and health for girls and mothers, which is very important for infant health) and 13 (climate action). Goal 3 is "good health and well-being," which includes targets for child mortality, maternal mortality, and reducing chronic disease. The Global Burden of Disease Project has confirmed that the majority of risk for these targets can be attributed to nutrition-related targets. Dietary Guidelines were developed to address public health nutrition risk in the Asia Pacific region at the 48th APACPH 2016 conference and they are relevant to the achievement of the SDGs. Iron deficiency increases the risk of maternal death from haemorrhage, a cause of 300000 deaths world-wide each year. Improving diets and iron supplementation are important public health interventions in the APACPH region. Chronic disease and obesity rates in the APACPH region are now a major challenge and healthy life course nutrition is a major public health priority in answering this challenge. This article discusses the role of public health nutrition in achieving the SDGs. It also examines the role of APACPH in education and advocacy and in fulfilling the educational needs of public health students in public health nutrition.

Matched MeSH terms: Maternal Death

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