Document Detail


Maternal mortality in Jamaica.
MedLine Citation:
PMID:  2869218     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A confidential inquiry into all maternal deaths in Jamaica during 3 years (1981 to 1983) was carried out. 192 maternal deaths were identified by a variety of means. The maternal mortality rate of 10.8 per 10 000 live births was considerably higher than the official rate of 4.8. The most common causes of death were hypertensive diseases of pregnancy (26%), haemorrhage (20%), ectopic pregnancy (10%), pulmonary embolus (8%), and sepsis (8%). Maternal mortality was closely related to both age and parity. The lowest rates were for women of para 2-4 aged 20-24 years and para 3-4 aged 25-29 years. The largest groups of avoidable factors were: non-use of and deficiencies in antenatal care; inadequacy in ensuring the delivery in hospital of women at high risk; and delays in taking action when signs of complications developed before, during, and after delivery.
This article reports the results of a review of all maternal deaths occurring in Jamaica in 1981-83. A total of 192 maternal deaths were identified, yielding a maternal mortality rate of 10.8/10,000 live births, which was considerably higher than the official rate of 4.8. 15% of these deaths were associated with abortion or ectopic pregnancy. The most common causes of death were hypertensive diseases of pregnancy (26%), hemorrhage (20%), ectopic pregnancy (10%), pulmonary embolus (8%), and sepsis (8%). Maternal mortality was closely related to both age and parity. Lowest rates were noted among women of para 2-4 aged 20-24 years and para 3-4 aged 25-29 years. Avoidable factors were judged to be present in 68% of the deaths. The largest categories of avoidable factors were: nonuse of and deficiencies in antenatal care; inadequacy in ensuring the delivery in hospital of high-risk women; and delays in taking action when signs of complications developed before, during, and after delivery. In response to these findings, the Ministry of Health's Maternal Mortality Committee has called for the following actions: measures to encourage women to seek antenatal care early in pregnancy; improvements in antenatal monitoring; the referral of high-risk women for hospital delivery; the definition of standard procedures for dealing with specific complications of pregnancy, e.g., eclampsia and hemorrhage; regionalization of obstetric services and criteria for referring patients to hospital; and review of provision of blood and plasma for emergency transfusions.
Authors:
G J Walker; D E Ashley; A M McCaw; G W Bernard
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  1     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1986 Mar 
Date Detail:
Created Date:  1986-04-02     Completed Date:  1986-04-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  486-8     Citation Subset:  AIM; IM; J    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Female
Humans
Hypertension / mortality
Infant, Newborn
Jamaica
Maternal Age
Maternal Mortality*
Middle Aged
Parity
Postpartum Hemorrhage / mortality
Pregnancy
Pregnancy Complications, Hematologic / mortality
Pregnancy Complications, Infectious / mortality
Pregnancy Trimester, Second
Pregnancy, Ectopic / mortality
Prenatal Care
Pulmonary Embolism / mortality

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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