A longitudinal study of near-miss and maternal mortality at a tertiary centre in rural Uttarakhand: addressing the fourth delay

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dc.contributor.authorMangla, Mishuen_US
dc.contributor.authorNautiyal, Ruchiraen_US
dc.contributor.authorDeepmalaen_US
dc.date.accessioned2020-10-16T07:58:10Z
dc.date.available2020-10-16T07:58:10Z
dc.date.issued2019-08
dc.description.abstractBackground: India is a signatory of the sustainable development goals and is committed to reduce the maternal mortality ratio to less than 70 per lakh live births. Review of maternal deaths and near miss cases is a very important step towards achieving this aim.Methods: A prospective observational study was carried out in a tertiary care centre in rural Uttarakhand for a period of one and half year using WHO criteria for maternal near-miss, in an attempt to assess the quality of obstetric care in the region and to identify the possible delays leading to this.Results: Haemorrhage was the most common cause leading to severe maternal outcome, followed by early pregnancy complications and hypertensive disorders of pregnancy. The mortality index was 15% and maternal near miss to mortality ratio was 7:1. We could identify some type of delay in at least 70% of near miss and mortality cases. Although delay in seeking healthcare was the most common, lack of community participation was identified as an important fourth delay.Conclusions: For substantive reduction of maternal mortality in this region of Uttarakhand, the main action needed is strengthening of primary health care, educating the patients regarding warning signs of pregnancy and strengthening the social status of women in society, increasing community support in women health care.en_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynecology, Himalayan Institute of Medical Sciences, Jollygrant, Dehradun, Uttarakhand, Indiaen_US
dc.identifier.citationMangla Mishu, Nautiyal Ruchira, Deepmala. A longitudinal study of near-miss and maternal mortality at a tertiary centre in rural Uttarakhand: addressing the fourth delay. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2019 Aug; 8(8): 3223-3228en_US
dc.identifier.issn2320-1770
dc.identifier.issn2320-1789
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/206944
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber8en_US
dc.relation.volume8en_US
dc.source.urihttps://dx.doi.org/10.18203/2320-1770.ijrcog20193539en_US
dc.subjectDelays in health careen_US
dc.subjectMaternal deathen_US
dc.subjectMaternal mortalityen_US
dc.subjectNear missen_US
dc.subjectRural Uttarakhanden_US
dc.subjectSevere maternal morbidityen_US
dc.titleA longitudinal study of near-miss and maternal mortality at a tertiary centre in rural Uttarakhand: addressing the fourth delayen_US
dc.typeJournal Articleen_US
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