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
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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 $irth.
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INTRODU"TION
#ERINATAL MORTALITY%&m$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.
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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.
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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$stetric
ca&ses per 100 000 deaths.
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R)*+,-%&./*
,./-&/-3
'-&
A
#-/)&
M3&)3/-%)*
M')%-3')*./'/*
L-&..+/*
S.%)-3%3-**
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"LASSIFI"ATION OF MATERNAL MORT D)/%& -&/-3 '-&*
dt o$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
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".)%)'&-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
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DIRE"T "AUSE3$ortion complication
regnancy ind&ced
high $lood press&re
O$str&cted la$o&r
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INDIRE"T "AUSES
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1. )itral and aortic stenosis
2. &lmonary hypertension
/. )arfan9s 8yndrome
". (isenmenger9s 8yndrome
5. eri part&m *ardiomyopathy !*)#
HEART DISEASES
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repregnancy co&nselling
*lose antenatal chec &p $y o$stetric
and cardic &nit
8ho&ld $e assessed $y specialist
'reat &nderlying condition
MANA;EMENT
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Other indirect deaths were recorded, incl&ding
1. *%8 epilepsy, s&$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
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DIS"USSION1<WHAT ARE THE MAIN
"AUSES OF MATERNALMORTALITY IN MALAYSIA=
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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#
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2<"OM#ARISON BETWEENMATERNAL MORTALITY RATE
$MMR( IN UK AND MMR INMALAYSIA
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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 -. *&-& /*)'&*
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UK
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MALAYSIA
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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
10,000 live $irth in 200
2= maternal deaths per
10,000 live $irth in 201
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<WHY IS OUR RATE ISHI;HER "OM#ARED TO
DEELO#ED "OUNTRIES=
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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$ility ofprimary health care and antenat
care for woman in the remote r&
areas
8ocioeconomic stat&s
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4<WHY IS HEART DISEASE IN#RE;NAN"Y AN IN"REASIN;
IN"IDEN"E FOR MATERNALMORTALITY=
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MITRAL STENOSIS
AORTI" STENOSIS
#ULMONARY HY#ERTENSION
HEART DISEASE
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)ost common valv&lar disease
*a&se mild growth retardation
Hypervolemia and tachycardia aggravate press&re
and vol&me gradient across mitral valve
6t can ca&se atrial fi$rillation and p&lmonary
edema
MITRAL STENOSIS
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*ongenital $ic&spid valve
3ortic stenosis !38# is the o$str&ction of $loodflow across the aortic valve
8ymptoms
yspnea
3ngina pectoris
8yncope
AORTI" STENOSIS
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6ncrease in the p&lmonary vasc&lar resistance
res<ing in an increased worload placed on the right
side of the heart.
8ymptoms
yspnea
@atig&e
8yncope *hest pain
#ULMONARY H#T
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6?:
reterm la$or
6ntra&terine fetal death
3$ortion
erinatal mortality
ADERSE EFFE"T OF HEARTDISEASE ON #RE;NAN"Y
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5<HOW "AN WE REDU"ETHE MATERNAL MORTALITY
RATE IN MALAYSIA=
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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 ) ) '
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< 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& ) ' ) )
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7< R-)' 'C3.& ., //-3 -3& */C)%* -' )/.C)-%%**))3)& &. -&/-3 -3& %-/
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#REENTION
#/)-/
Health ed&cation
S%.'-/
3ntenatal care
Home visitsn&rsing of postnatal mothers $y
health staff !hospitalhome#T/&)-/
)aternal mortality notification and
s&rveillance