exudates and Postpartum-Hemorrhage

Topics: Female; Humans; Malaysia; Postpartum Hemorrhage; Risk Factors

A confidential system of enquiry into maternal mortality was introduced in Malaysia in 1991. The methods used and the findings obtained up to 1994 are reported below and an outline is given of the resulting recommendations and actions.. This is a report on the methods, findings, resulting recommendations and actions of a study on maternal mortality in Malaysia during the period 1991-94. Maternal death was defined as the death of a woman while pregnant or within 42 days following termination of pregnancy from any cause related to the pregnancy or its management but not from accidental causes. Between 1991 and 1994 there were 1066 reported maternal deaths, and the maternal mortality ratios for the successive years were respectively 44, 48, 46 and 39 per 100,000 live births. The primary causes of maternal death were postpartum hemorrhage (24%), hypertensive disorders of pregnancy (16%), obstetric pulmonary embolism (13%), and associated medical conditions (7%). Analysis of the 375 deaths from 1992 - 1993 showed that the maternal mortality ratio was 53/100,000 live births for deliveries performed at home, 36/100,000 in government hospitals, and 21/100,000 in private institutions. Shortcomings among health personnel were detected in several cases; these involved failure to diagnose, failure to appreciate the severity of a patient's condition, inadequate therapy, and inappropriate, delayed or failed adherence to protocols. The high proportion of maternal mortality associated with substandard care demonstrates that it is important to make the standard of care more widely available. Reports have been circulated to institutions and organizations providing maternal care and to medical schools. Articles and case histories have been published, and many new protocols and procedures have been developed. Furthermore, seminars have been organized and training modules have been distributed to all involved in the provision of maternity care.

Topics: Adolescent; Adult; Cause of Death; Female; House Calls; Humans; Malaysia; Maternal Mortality; Postpartum Hemorrhage; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Prenatal Care; Puerperal Infection; Pulmonary Embolism

Trends in selected pregnancy complications from 1969 to 1987 in a tertiary hospital in Malaysia are presented. Complications reviewed were abortion, ectopic pregnancy, anemia, hypertension, hyperemesis, antepartum and postpartum hemorrhage. Possible explanations for the observed trends were discussed, including the role of improved obstetric care and changes in the characteristics of the childbearing population. The data presented give some indication of maternal morbidity in the childbearing population served by this tertiary center and should lead to improvements in provision of services as well as in health data collection in the future.

Topics: Abortion, Spontaneous; Anemia; Female; Hemorrhage; Humans; Hyperemesis Gravidarum; Hypertension; Malaysia; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications; Pregnancy Complications, Cardiovascular; Pregnancy Complications, Hematologic; Pregnancy, Ectopic

Caesarean hysterectomy is a useful surgical procedure. However, the increased blood supply to the pelvis during pregnancy, distortion of the anatomy caused by the enlarged uterus, fragility of oedematous pelvic tissues and adhesions from prior caesarean sections predispose to poor haemostasis and urinary tract injuries. In this series all the cases were done as an emergency procedure and, despite the multiple obstetric complications, there was no maternal mortality and the incidence of post-operative morbidity was low.

Topics: Adolescent; Adult; Cesarean Section; Female; Humans; Hysterectomy; Malaysia; Placenta Accreta; Postoperative Complications; Postpartum Hemorrhage; Pregnancy; Retrospective Studies; Uterine Rupture

Topics: Female; Humans; Malaysia; Maternal Mortality; Postpartum Hemorrhage; Pregnancy; Singapore

Topics: Anemia; Anemia, Hypochromic; Female; Humans; Infant Mortality; Malaysia; Maternal Mortality; Maternal Welfare; Obstetrics; Postpartum Hemorrhage; Postpartum Period; Pre-Eclampsia; Pregnancy; Rural Health; Statistics as Topic; Vital Statistics