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Epidemiology in Indonesia, The Problem and The Challenge in Reducing Maternal Mortality Rate PDF
Epidemiology in Indonesia, The Problem and The Challenge in Reducing Maternal Mortality Rate PDF
Hermanto TJ
* Reproductive Health Magister Program
FoM UA
*Division of MaternalFetal Medicine Dep
ObGyn RS dr Soetomo
Different perspective
Facts on PASD
• Difficult diagnosis – especially asses the adnex and
cervix involvement
• Management – high morbidity and high mortality – widely
interconnected vascular system incl extra aorta
• Pathophysiology not completely understood but related
with cesarean delivery
• Cesarean delivery still high in number – increasing
number of PASD
• One cesarean delivery PASD phenomena
PASD at dr Soetomo Teaching
Hospital
World trend in Cesarean
Delivery(CD)
Indonesia dichotomy (Anne Hyre – EMAS:
the Mystery of Maternal Mortality in
Indonesia 2016)
• Economy growth 5-6 & yearly since 2000
• Literacy rate 92 %
• Contraceptive prevalence 60 %
• High antenatal care, skilled attendant at birth, facility-
based at birth
• More than 200000 midwives
yet