In Malaysia, Maternal Mortality is quantified as a ratio (this is NOT the same as Maternal Mortality Rate).
Maternal Mortality Ratio is defined as the number of maternal deaths per 100,000 live births. The current MMR for Malaysia is in the region of 28/100,000 live births.
According to the last CEMD report (1997-2000), the 4 main causes are:
1. Associated Medical Conditions 20.6%
2. Post Partum Haemorrhage 19.1%
3. Hypertensive Disorders 14.1%
4. Obstetric Embolism 13.9%
To make a comparison with other countries, see here and here.
How can we improve the MM Ratio?
All forms of training in O&G should emphasize on the above 4 main causes. (Undergraduate training, Housemanship training, Postgraduate training). Here are some specific strategies:
Associated Medical Conditions:
a. Establishment of Combined Clinic
b. Seminars / Courses to refresh Doctors' experience in Internal Medicine - better if O&G Doctors undergo periodic attachments in specific areas of Internal Medicine.
c. The scope of premarital screening should be widened to include a medical examination OR
d. Newly married couples should be encouraged to seek pre-conceptual counseling (provide tax-breaks, dedicated clinics, etc)
e. Heavier forcus on Maternal Medicine within the branch of Maternal Fetal Medicine
This post will be updated soon.