Four Main Reasons that Mothers Die during Pregnancy and Childbirth!

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  • Early motherhood risk & Unsafe Abortion

Complexity during pregnancy and childbirth are the leading cause of death in young women aged 15 to 19 in developing countries, warned a report published last week. Many adolescent mothers die each year because they have children before they are physically not ready for parenthood, Overall, a third of women from developing countries gave birth before the age of 20—ranging from 8% in east Asia to 55% in west Africa. Analysis of the most recent and best quality data from government statistics for different countries or from international surveys showed that complications from pregnancy and childbirth were the leading cause of death for girls aged 15 to 19 years in poorer countries.

Adolescent women face a high risk of unintended pregnancies and unsafe abortions, with devastating consequences for their lives and health. Around  world, every minute, nearly 40 desperate women undergo an unsafe abortion; at least one-fourth of these women are girls aged 15-19.

  • Infection in Pregnancy

Pregnant women are a special high risk of acute infections.

Maternal risk: The unique immunologically suppressed state of pregnancy makes infections like influenza, malaria, hepatitis E, and herpes simplex virus (HSV) infection severe. Evidence also exists for increased severity of measles, smallpox, malaria, HIV infection, and listeriosis.

Fetal risk: Congenital infections, intra-uterine growth retardation (IUGR), abortion or fetal death.  

Diagnostic inference: Pregnant women may not mount an adequate burning response masking the presence of infections. Acute fevered illnesses may stimulated other conditions like acute fatty liver of pregnancy and haemolysis, elevated liver enzymes and low platelet count (HELLP) syndromes.

Treatment implications: Drugs like Prophylaxis (live vaccines) and other certain drugs may not be safe in pregnancy.

  • Severe Bleeding

Vaginal bleeding during pregnancy has many causes. Some are serious, whereas others are not. Bleeding can occur early or later in pregnancy. Bleeding in early pregnancy is common. In more cases, it does not indicate a major problem. Bleeding later in pregnancy can be more serious. Problems that may cause bleeding in early pregnancy include infection, early pregnancy loss, and ectopic pregnancy.

  • Hypertensive Disorders:

Hypertensive disorders complicating pregnancy are one of the common and significant cause of maternal morbidity and mortality especially in developing countries. They are responsible for 8-9% of maternal deaths in India and 15 -20% of maternal deaths in western world. Overall they complicate 5-10% of pregnancies in India. There is seasonal variation in occurance, higher incidence in monsoon season. Hypertensive disorders of pregnancy represent a spectrum of disease ranging from chronic and gestational hypertension to eclampsia. They are associated with increased risk of both adverse maternal and fetal outcomes.

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