1. PREVENTION OF MATERNAL MORTALITY IN INDIA – ROLE OF IMA Dr. Vasudeva Panicker, National coordinator 1

2. 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. 2

3. GLOBAL SENARIO OF MMR - 2010 Maternal Mortality Ratio (MMR) is very high in India. 3 RegionMMR /1,00,000 live birth (2010) INDIA 200 USA21 NEW ZEALAND15 UK12 SWITZERLAND8 FRANCE8 SRILANKA35 NEPAL170 BENGLADESH240 PAKISTHAN260

4. MMR IN DIFFERENT STATES STATES BIRTH RATE MMR PHCs/ UFWs BIRTHS RELATIVE MARGIN ERROR ANDHRA PRADES21.3 154 352236522% ASSAM26.9 401 1310491 8% BIHAR31.9 451 2019140 5% JHARKHAND26.5 451 10 7950 7% GUJARAT25.2 135 453402022% HARYANA26.9 196 151210521% HIMANCHAL PRADESH21.5 196 251612518% JAMMU & KASHMIR19.6 196 251470019% KARNATAKA22.0 217 301980014% KERALA17.9 195 3719869 16% MADHYA PRADESH31.2 498 1514040 5% CHHATISGARH26.7 498 10 8010 6% MAHARASHTRA22.0 183 402508016% ORISSA24.3 361 2014580 8% PUNJAB21.5 196 251612518% RAJASTHAN31.2 677 10 9360 4% TAMIL NADU19.2 195 372131216% UTTAR PRADESH30.0 600 1012000 4% UTTARANCHAL20.2 297 181272611% WEST BENGAL20.6 264 301854011% CHANDHI GARH17.5 196 121050022% DELHI20.3 172 151522523% North East States26.9 401 108070 9% 4

5. 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. 5

6. Factors contributing to Maternal Death 1.Age 2.Parity 3.Socio Economic State 4.Antenatal Care 5.Environmental Factors 6

7. 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 7

8. 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. 8

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10. Levels of Maternal Mortality Rate by Regions, 1997-2012 10

11. THANK YOU