PREVENTION OF MATERNAL MORTALITY IN INDIA – ROLE OF IMA

Dr. Vasudeva Panicker,

National coordinator

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DEFINITION OF MATERNAL MORTALITY

• The maternal mortality rate (MMR) is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes).

• The MMR includes deaths during pregnancy, childbirth, or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, for a specified year.

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GLOBAL SENARIO OF MMR - 2010• Maternal Mortality Ratio (MMR) is very high in India.

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Region MMR /1,00,000 live birth (2010)

INDIA 200

USA 21

NEW ZEALAND 15

UK 12

SWITZERLAND 8

FRANCE 8

SRILANKA 35

NEPAL 170

BENGLADESH 240

PAKISTHAN 260

MMR IN DIFFERENT STATES• STATES BIRTH RATE MMR PHCs/ UFWs BIRTHS RELATIVE MARGIN ERROR • ANDHRA PRADES 21.3 154 35 22365 22%• ASSAM 26.9 401 13 10491 8%• BIHAR 31.9 451 20 19140 5%• JHARKHAND 26.5 451 10 7950 7%• GUJARAT 25.2 135 45 34020 22%• HARYANA 26.9 196 15 12105 21%• HIMANCHAL PRADESH 21.5 196 25 16125 18%• JAMMU & KASHMIR 19.6 196 25 14700 19%• KARNATAKA 22.0 217 30 19800 14%• KERALA 17.9 195 37 19869 16%• MADHYA PRADESH 31.2 498 15 14040 5%• CHHATISGARH 26.7 498 10 8010 6%• MAHARASHTRA 22.0 183 40 25080 16%• ORISSA 24.3 361 20 14580 8%• PUNJAB 21.5 196 25 16125 18%• RAJASTHAN 31.2 677 10 9360 4%• TAMIL NADU 19.2 195 37 21312 16%• UTTAR PRADESH 30.0 600 10 12000 4%• UTTARANCHAL 20.2 297 18 12726 11%• WEST BENGAL 20.6 264 30 18540 11%• CHANDHI GARH 17.5 196 12 10500 22%• DELHI 20.3 172 15 15225 23%• North East States 26.9 401 10 8070 9%

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Causes of Maternal Death

1. Direct Obstetric Causes – Complication of pregnancy, delivery or their management.

like Abortion, Ectopic pregnancy, PET, Eclampsia, APH, PPH, Sepsis etc.

2. Indirect Causes – Conditions, Present or developed and aggravated during pregnancy.

like Anemia, Cardiac disease, Thyroid disease, Diabetics, Viral hepatitis etc.

3. Non Obstetric Causes – Accidents, Malaria and other infectious disease.

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Factors contributing to Maternal Death

1. Age

2. Parity

3. Socio Economic State

4. Antenatal Care

5. Environmental Factors

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Steps to reduce Maternal Mortality

1. Correction of Anemia

2. Treatment of pre-existing diseases

3. Treatment of PIH Eclampsia

4. Treatment of Diabetics

5. Thrombo prophylaxis

6. Management of Obstetric Hemorrhage

7. Management of Sepsis

8. Emergency Obstetric Care

9. Treatment of Amniotic fluid Embolism

10.Treatment of pregnancy related serious diseases

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Role of IMA in preventing Maternal Death

• Awareness generation among antenatal and women in general

• Empowering non obstetrician doctors for safe conduct of delivery, EOC and treatment of PPH.

• CME’s on steps to prevent maternal mortality in all IMA branches.

• Empowering to identify warning signals and for prompt referral - in home deliveries attended by non medical personnel .

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Levels of Maternal Mortality Rate by Regions, 1997-2012

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THANK YOU