OS018. Maternal mortality and its mainly possible causepre-eclampsia/eclampsia in developing country...

By slow decrease of Indonesia's 2010 highly maternal mortality rate (MMR) as 228/100,000 births mostly estimated to be out reach toward 2014 MDG target achievement of 118/100,000 births, even maternal deaths are notoriously under reported, possibly at least by as much as quarter. The population of Indonesia according to the 2010 national census is 237.6 million, with 58% living on the island of Java, the world's most populous island since it is only 6% of Indonesia total area. Despite risk approaching strategy and referral method in Indonesia national health system had already been formed but the application has not been optimal yet so that its achievement is still far from destination.

To study the correlationship between maternal mortality rate and its mainly possible cause pre-eclampsia/eclampsia

Retrospectively study was performed by using data Dr. Soetomo teaching hospital Surabaya and local government of East Java.

Before the year 2008 the maternal deaths on our hospital Dr. Soetomo Surabaya was depicted very high as approximate 713/100,000 births (range 5.05-10.24 per 100,000 births) or 105 maternal deaths among 14,712 births. Pre-eclampsia/eclampsia was the most possible cause rate of 50-65%. Although at present tend to be improved situation but the year 2008 classic data indicated bad referral system application of severe pre-eclampsia and eclampsia cases that they came lately into our teaching hospital's intensive care unit with approximately 12.6% major complications consist of 50% lung oedema and the remain with placental abruption and cerebral bleeding. In more detailed description of maternal deaths as 29% died on the day 1 of intensive care unit treatment that some cases were death on arrival, 35% on the day 1-3 and >day 3 showed 36% of deaths. Even 40% our preeclampsia/eclampsia dominated ventilator use in hospital ICU due to >60% lung oedema that almost those 70% persist until 3 days (72h) in respiratory machine use. Our Dr. Soetomo hospital Surabaya as the tertiary hospital and referral center as well we observed 210 cases of severely pre-eclampsia which divided into 40 cases of early onset and late onset type as 170 cases by the year 2010. Mainly the characteristic features in early onset type as follow 70% they were reproductive ages (20-35 years old), 60% was 24-32 gestational weeks, 12.5% got complication of Hellp syndrome, 25% with low albumin serum level (<3g%) and had renal failure as 40%.

Despite Indonesia MMR apparently declined over last two decades but it did not slump as expected even it failed to achieve the 2014 MDG's target.