Applying the new concept of maternal near-miss in an intensive care unit
Clinics
; 67(3): 225-230, 2012. tab
Article
in En
| LILACS
| ID: lil-623095
Responsible library:
BR1.1
ABSTRACT
OBJECTIVES:
The World Health Organization has recommended investigating near-misses as a benchmark practice for monitoring maternal healthcare and has standardized the criteria for diagnosis. We aimed to study maternal morbidity and mortality among women admitted to a general intensive care unit during pregnancy or in the postpartum period, using the new World Health Organization criteria.METHODS:
In a cross-sectional study, 158 cases of severe maternal morbidity were classified according to theiroutcomes:
death, maternal near-miss, and potentially life-threatening conditions. The health indicators for obstetrical care were calculated. A bivariate analysis was performed using the Chi-square test with Yate's correction or Fisher's exact test. A multiple regression analysis was used to calculate the crude and adjusted odds ratios, together with their respective 95% confidence intervals.RESULTS:
Among the 158 admissions, 5 deaths, 43 cases of maternal near-miss, and 110 cases of potentially lifethreatening conditions occurred. The near-miss rate was 4.4 cases per 1,000 live births. The near-miss/death ratio was 8.6 near-misses for each maternal death, and the overall mortality index was 10.4%. Hypertensive syndromes were the main cause of admission (67.7% of the cases, 107/158); however, hemorrhage, mainly due to uterine atony and ectopic pregnancy complications, was the main cause of maternal near-misses and deaths (17/43 cases of near-miss and 2/5 deaths).CONCLUSIONS:
Hypertension was the main cause of admission and of potentially life-threatening conditions; however, hemorrhage was the main cause of maternal near-misses and deaths at this institution, suggesting that delays may occur in implementing appropriate obstetrical care.Key words
Full text:
1
Index:
LILACS
Main subject:
Pregnancy Complications
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Maternal Mortality
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Hypertension, Pregnancy-Induced
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Postpartum Hemorrhage
Type of study:
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limits:
Adolescent
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Adult
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Female
/
Humans
/
Pregnancy
Language:
En
Journal:
Clinics
Journal subject:
MEDICINA
Year:
2012
Type:
Article
/
Project document