Transcript PREVENTION OF MATERNAL MORTALITY IN INDIA

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.
Region
INDIA
MMR /1,00,000 live birth (2010)
200
USA
21
NEW ZEALAND
15
UK
12
SWITZERLAND
8
FRANCE
8
SRILANKA
35
NEPAL
170
BENGLADESH
240
PAKISTHAN
260
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MMR IN DIFFERENT STATES
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STATES
ANDHRA PRADES
ASSAM
BIHAR
JHARKHAND
GUJARAT
HARYANA
HIMANCHAL PRADESH
JAMMU & KASHMIR
KARNATAKA
KERALA
MADHYA PRADESH
CHHATISGARH
MAHARASHTRA
ORISSA
PUNJAB
RAJASTHAN
TAMIL NADU
UTTAR PRADESH
UTTARANCHAL
WEST BENGAL
CHANDHI GARH
DELHI
North East States
BIRTH RATE
21.3
26.9
31.9
26.5
25.2
26.9
21.5
19.6
22.0
17.9
31.2
26.7
22.0
24.3
21.5
31.2
19.2
30.0
20.2
20.6
17.5
20.3
26.9
MMR
154
401
451
451
135
196
196
196
217
195
498
498
183
361
196
677
195
600
297
264
196
172
401
PHCs/ UFWs
35
13
20
10
45
15
25
25
30
37
15
10
40
20
25
10
37
10
18
30
12
15
10
BIRTHS
22365
10491
19140
7950
34020
12105
16125
14700
19800
19869
14040
8010
25080
14580
16125
9360
21312
12000
12726
18540
10500
15225
8070
RELATIVE MARGIN ERROR
22%
8%
5%
7%
22%
21%
18%
19%
14%
16%
5%
6%
16%
8%
18%
4%
16%
4%
11%
11%
22%
23%
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.
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Age
Parity
Socio Economic State
Antenatal Care
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