Maternal Mortality Posting 4th

7/26/2019 Maternal Mortality Posting 4th

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SEMINAR TWO:MATERNAL MORTALITYNURUL AMIRAH HANNAH BINTI RAHAZI 2012425188

NURUL SYAZWIN BINTI MOHAMMED ANUAR 2012429784

MUHAMMAD FIKRI BIN JOHARI 2012289598

NOR SYAZWANI BINTI ISMAIL 20126566

SARAH BINTI MUHAMMAD SALIM 201264256

TUAN ANIS AFIFI BINTI TUAN AZIZEE 2012645776

NURUL SYAFI!AH BINTI MOHD SAFRI 2012652084



INTRODU"TION

While pregnancies are often a positive

experience, WHO states that everyday, 1500women die from pregnancy-related

complications.

#ERINATAL #ERIOD22 completed wees !15" days# of gestation

and ends seven completed days after $irth.



INTRODU"TION

#ERINATAL MORTALITY%&m$er of still$irths and deaths in the first

wee of life !early neonatal mortality#.

MATERNAL HEALTH

Health of women d&ring pregnancy, child$irth

and the postpart&m period.



INTRODU"TION $%&'(

#ERINATAL MORTALITY

%&m$er of still$irths and deaths in the first

wee of life !early neonatal mortality#.

MATERNAL HEALTH

Health of women d&ring pregnancy, child$irth

and the postpart&m period.



INTRODU"TION $%&'(

MATERNAL MORTALITY

'he death of a woman while pregnant or within

"2 days of termination of pregnancy.

(xcl&ding accidental or incidental ca&ses.

MATERNAL MORTALITY RATE

%&m$er or maternal deaths from o$stetric

ca&ses per 100 000 deaths.







R)*+,-%&./*

,./-&/-3

'-&

A

#-/)&

M3&)3/-%)*

M')%-3')*./'/*

L-&..+/*

S.%)-3%3-**



"LASSIFI"ATION OF MATERNAL MORT D)/%& -&/-3 '-&*

dt o$stetric complications of the pregnant state!pregnancy, la$o&r, and p&erperi&m#

(g ostpart&m haemorrhage and amniotic fl&id em$olism

I')/%& -&/-3 '-&*

3rise from pre-existing disease or disease that developed

d&ring pregnancy

#/-%/3-&' '-&*

eath occ&rring in a woman while pregnant or within "2 day

of termination of pregnancy, irrespective of the ca&se of

death which incl&des accidental and incidental ca&ses



".)%)'&-3 $,./&)&.*( -&/-3 '-&

eath d&ring pregnancy, child$irth and the p&erperi&m d&e

to external ca&ses. (g

ara+&at poisoning

oad traffic accidents

L-& '-&*

Occ&rring $etween "2 days and 1 year after a$ortion,

miscarriage or delivery that are d&e to direct or indirect

maternal ca&ses



DIRE"T "AUSE3$ortion complication

regnancy ind&ced

high $lood press&re

O$str&cted la$o&r



INDIRE"T "AUSES





1. )itral and aortic stenosis

2. &lmonary hypertension

/. )arfan9s 8yndrome

". (isenmenger9s 8yndrome

5. eri part&m *ardiomyopathy !*)#

HEART DISEASES



repregnancy co&nselling

*lose antenatal chec &p $y o$stetric

and cardic &nit

8ho&ld $e assessed $y specialist

'reat &nderlying condition

MANA;EMENT



Other indirect deaths were recorded, incl&ding

1. *%8 epilepsy, s&$arachnoid and intracere$ral haemorrhage

2. 6nfectio&s diseases H6 infection

/. espiratory system asthma

". (ndocrine dia$etes

5. :6' pancreatitis

;. Hematology anemia<. *irc&latory system

. 6ndirect malignancies

=. *a&se &nnown

10. Other

OTHERS



DIS"USSION1<WHAT ARE THE MAIN

"AUSES OF MATERNALMORTALITY IN MALAYSIA=



T -) %-** ., '-& -/: postpart&m hemorrhage !2"7#

indirect ca&ses s&ch as anemia, malaria, and heart

disease !207# infection !157#

&nsafe a$ortion !1/7#

eclampsia !127#

o$str&cted la$or !7#

ectopic pregnancy, em$olism, and anesthesia

complications !7#





2<"OM#ARISON BETWEENMATERNAL MORTALITY RATE

$MMR( IN UK AND MMR INMALAYSIA



HOW TO "AL"ULATE MATERNALMORTALITY RATE=

MMR > NO OF MATERNAL DEATHS ? 10@000 NO OF LIE BIRTHS

E-3*:• 84 -&/-3 '-&* ) 2008 -. *&-& /*)'&*•

10@000 3)C )/&* ) 2008 &. *&-& /*)'&*

• 8410@000 100@000 > 64<6 -&/-3 '-&*/100@000 3)C )/&* ) 2008 -. *&-& /*)'&*



UK



MALAYSIA



UNITED KIN;DOM

12 maternal deaths per

10,000 live $irth from

200-2010

"OM#ARE

MALAYSIA

/1 maternal deaths per

10,000 live $irth in 200

/0 maternal deaths per


2= maternal deaths per




<WHY IS OUR RATE ISHI;HER "OM#ARED TO

DEELO#ED "OUNTRIES=



UNITED KIN;DOM

8ocial disadvantage

>ate $ooing or poor attendance

elayed pregnancy

O$esity

omestic violence

8&$stance a$&se

WHY=

MALAYSIA

8ocial disadvantage

>ate $ooing or poor attendance

elayed pregnancy

elivery cond&cted $y ?ntrained

'raditional 4irth 3ttendant !'43

the r&ral areas

3ccessi$ility and availa$ility ofprimary health care and antenat

care for woman in the remote r&

areas

8ocioeconomic stat&s



4<WHY IS HEART DISEASE IN#RE;NAN"Y AN IN"REASIN;

IN"IDEN"E FOR MATERNALMORTALITY=



MITRAL STENOSIS

AORTI" STENOSIS

#ULMONARY HY#ERTENSION

HEART DISEASE



)ost common valv&lar disease

*a&se mild growth retardation

Hypervolemia and tachycardia aggravate press&re

and vol&me gradient across mitral valve

6t can ca&se atrial fi$rillation and p&lmonary

edema

MITRAL STENOSIS



*ongenital $ic&spid valve

3ortic stenosis !38# is the o$str&ction of $loodflow across the aortic valve

8ymptoms

yspnea

3ngina pectoris

8yncope

AORTI" STENOSIS



6ncrease in the p&lmonary vasc&lar resistance

res&lting in an increased worload placed on the right

side of the heart.

8ymptoms

yspnea

@atig&e

8yncope *hest pain

#ULMONARY H#T



6?:

reterm la$or

6ntra&terine fetal death

3$ortion

erinatal mortality

ADERSE EFFE"T OF HEARTDISEASE ON #RE;NAN"Y



5<HOW "AN WE REDU"ETHE MATERNAL MORTALITY

RATE IN MALAYSIA=



FA"TORS THAT REDU"E MORTALITYRATE IN MALAYSIA

1< S-, '3)C/.elivery that is attend $y silled health personal.

6ncreasing esta$lishment of n&rsing and midwifery schools.

6ncrease in the n&m$er of trained health personnel

6mproved midwifery and o$stetric sills

2< I/.C' %.C/- -' /'%&). ) )/)*+ /-%)*. 6ntrod&ction of High is 3pproach in )*H

high ris mother were identified and referred to the

hospital

I ) 3) , )3 3 ) ) '



< I/.C& ) -3)& ,-)3 3-) */C)%* -'),./-&).

:ro&ps nown to have relatively higher riss of maternal

mortality.

(specially in the context of rising levels of H6368.

4< ;.C/& %.)&&

3de+&ate allocation of reso&rces, incl&ding financial,

manpower, and physical infrastr&ct&re.

5< U/-'* ) & -3)& ., **&)-3 .*&&/)% %-/ ) ')*&/)%&.*)&-3*@ )& - ,.%* . /% .*&&/)% %-/ */C)%*

6< W./+' %3.*3 )& %.)&)* &. /.C *.%)-3 -'%3&/-3 %.*&/-)&* -' )/.C -%%&-)3)& ., .'/-&/-3 -3& */C)%*

R )' ' 3 & , 3 3& ) ' ) )



7< R-)' 'C3.& ., //-3 -3& */C)%* -' )/.C)-%%**))3)& &. -&/-3 -3& %-/



#REENTION

#/)-/

Health ed&cation

S%.'-/

3ntenatal care

Home visitsn&rsing of postnatal mothers $y

health staff !hospitalhome#T/&)-/

)aternal mortality notification and

s&rveillance



RE"OMMENDATION

6mplementing pre-pregnancy

care

'o train more physicians in

O$stetric )edicine and get

more o$stetrician in maternal

medicine 8afe deliveries among pregnant

adolescents

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Maternal Mortality Posting 4th

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