Gil GI, Díaz SY, Rodríguez LJF, Quincoces PM, Álvarez TM

Language: Spanish
References: 23
Page: 290-300
PDF size: 107.23 Kb.

ABSTRACT

Introduction: analysis of extremely serious maternal morbidity may have a significant interpretation when approached from a new epidemiological standpoint in our context, for it is an indicator of extraordinary social sensitivity of the quality of maternal care which contributes to decision making based on scientific grounds for the strengthening of healthcare.
Objectives: characterize extremely serious maternal morbidity in Villa Clara in the year 2012.
Methods: a cross-sectional study was conducted with all the patients diagnosed with extremely serious maternal morbidity in hospitals with obstetrics and gynecology services in the province. Classification criteria were applied. Prenatal and hospital medical records were used as data sources.
Results: the highest percentage of cases with extreme maternal morbidity was found in Mariana Grajales Hospital. These were diagnosed after delivery, mostly when caesarean sections were performed. Average age was 28 years. Maternal risks were identified in 82.1% of the patients. the most common were hypertensive disorders, vaginal infection, anemia and extreme age. The most frequent causes were related to the management performed. Obstetric hemorrhage was the main cause of hospital admission in the intensive care unit and of additional surgery.
Conclusions: obstetric hemorrhage and hypertensive disorders are the main causes of extremely serious maternal morbidity, leading to most admissions in the intensive care unit and to surgical and transfusional treatment.

REFERENCES

1. Organización Mundial de la Salud. Centro de prensa. Mortalidad materna disminuye demasiado lentamente [Internet] Ginebra: OMS; 2007 [citado 5 mayo 2013]. Disponible en: http://www.who.int/mediacentre/news/releases/2007/pr56/es/index.html

2. Fondo de las Naciones Unidas para la Infancia. Estado mundial de la infancia 2009 [Internet]. Nueva York: UNICEF; 2008. [citado 5 mayo 2013]. Disponible en: http://www.unicef.org/spanish/sowc09/docs/SOWC09-FullReport-ESP.pdf

3. Ministerio de la Protección Social. Capacitación e implementación en la metodología de la vigilancia de la mortalidad materna extrema externa en diez direcciones territoriales de salud. Bogotá: Secretaria Distrital de Salud; 2008. [citado 5 mayo 2013] Disponible en: http://www.unfpacolombia.org/home/unfpacol/public_htmlfile/PDF/PLAN_DE_M_&_ E_2008%5B1%5D.pdf

4. Instituto Nacional de Salud. Presentación de resultados de prueba piloto para la vigilancia epidemiológica de la Morbilidad materna Extrema en Instituciones de Centinelas. Bogotá: INS; 2011[citado 5 mayo 2013] Disponible en: http://www.unfpacolombia.org/home/unfpacol/public_htmlfile/PDF/PLAN_DE_M_&_ E_2008%5B1%5D.pdf

5. Carbonell García IC, López Barroso R, Alba Arias Y, Gómez Padró T, Smith Salazar L, Álvarez Toste M, et al. Caracterización clínico-epidemiológica de la morbilidad materna extremadamente grave. Santiago de Cuba 2009. Rev Cub Hig Epidemiol [Internet] 2009. [citado 5 mayo 2013];47(3). Disponible en: http://www.bvs.sld.cu/revistas/hie/vol47_3_09/hie06309.pdf

6. Álvarez Toste M, Salvador Álvarez S, González Rodríguez G, Pérez DR. Caracterización de la morbilidad materna extremadamente grave. Rev Cub Hig Epidemiol [Internet] 2009. [citado 5 mayo 2013];47(3). Disponible en: http://www.redalyc.uaemex.mx/sre/inicio/artpdfredjsp?Cve=223217614010

7. Khan Chalid S. WHO Analysis of Causes of Maternal Death: A systematic review. The Lancet. [Internet]. 2006 [citado 5 mayo 2013];367(9516):1066-74. Available from: http://www.thelancet.com/journals/lancet/article/PIIS0140-67

8. Say L, Pattinson RC, Gulmezoglu AM. WHO systematic review of maternal morbidity and mortality: The prevalence of severe acute maternal morbidity (near miss). Reprod Health. [Internet]. 2004 Aug 17[citado 5 mayo 2013];1(1):3-4. Available from: http://www.reproductive-health-journal.com/content/1/1/3

9. Geller SE, Rosenberg D, Cox S, Brown M, Simonson L, Kilpatrick S. A scoring system identified near miss maternal morbidity during pregnancy. J Clin Epidemiol [Internet]. 2004 [citado 5 mayo 2013];57(7):716-20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15358399

10. MDG 5. Improve maternal health [Internet]. In: Potential contributions to the MDG agenda from the perspective of ICPD. Brasilia: United Nations Population Fund, c2008. [citado 5 mayo 2013] p. 277-300. Available from: http://www.unfpa.org.br/lacodm/arquivos/mdg5.pdf

11. Chen PJ. Pregnancy in older. University of Maryland Medical Center. [Internet] Baltimore: University of Maryland Medical Center (UMMC); © 2010 [citado 5 mayo 2013]. Available from: http://www.umm.edu/pregnancy_spanish/000201.htm

12. Benzies KM. Advanced maternal age: Are decisions about the timing of childbearing a failure to understand the risks? CMAJ [Internet]. 2008 [citado 9 mayo 2013];178(2):[about 6 p.]. Available from: http://www.cmaj.ca/cgi/content/abstract/178/2/165

13. García IA, Alemán Mederos MM. Riesgos del embarazo en la edad avanzada. Rev Cubana Obstet Ginecol [Internet]. 2010 [citado 9 mayo 2013];36(4): [aprox. 6 p]. Disponible en: http://www.scielo.sld.cu/scielo.php?pid=S0138- 600X2010000400002&script=sci_arttext

14. Álvarez Sintes R. Medicina General Integral. Volumen I. Salud y medicina [Internet]. La Habana: Editorial Ciencias Médicas. 2008 [citado 9 mayo 2013]. Disponible en: http://www.bvs.sld.cu/libros_texto/mgi_tomoi_seg_edicion/indice_p.htm

15. Rodríguez Núñez AC, Córdova A, Álvarez M. Factores epidemiológicos que influyen en la morbilidad puerperal grave. Cuba. Rev Cubana Obstet Ginecol [Internet]. 2004 [citado 9 mayo 2013];30(3). Disponible en: http://www.scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138- 600X2004000300006&lng=es&nrm=iso&tlng=es

16. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S, et al. Births: Final Data for 2006. National Vital Statistics Reports [Internet] 2009 Jan. [cited 2013 May 5];57(7):[about 102 p.]. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_07.pdf

17. Cleary-Goldman J, Malone FD. Impact of maternal age on obstetric outcome. Obstetrics and Gynecology [Internet]. 2005 may [cited 2013 May 5];105(5):983- 90. Available from: http://www.journals.lww.com/greenjournal/fulltext/2005/05000/impact_of_matern al_age_on_obstetric_outcome.11.aspx

18. Díaz Mayo J, Pérez Aseef A, Naranjo Igarza S. Morbilidad materna en la unidad de cuidados intensivos en el Hospital General Docente "Enrique Cabrera". Rev Cub Obstet Ginecol [Internet]. 2006 [citado 5 mayo 2013];3(2):45-9. Disponible en: http://www.bvs.sld.cu/revistas/hie/vol47_3_09/hie06309.pdf

19. Herrera JA. Evaluación del riesgo obstétrico en el cuidado prenatal. Colombia Médica [Internet]. 2002 [citado 9 mayo 2013];21(5): [aprox. 6 p]. Disponible en: http://www.redalyc.uaemex.mx/redalyc/html/283/28333104/28333104.html

20. Munnur U, Karnard D, Bandi VD. Critically ill obstetric patients in an American and an Indian public hospital: comparison of case-mix, organ dysfunction, intensive care requirements, and outcomes. Intensive Care Med [Internet]. 2005 [citado 5 mayo 2013];31(8):1087-94. Available from: http://www.springerlink.com/content/p0rh013j7x2080m2/fulltext.pdf

21. Vázquez Cabrera J. Principales complicaciones [Internet]. Operación cesárea. En: Embarazo, parto y puerperio. La Habana: Editorial Ciencias Médicas; 2009. p. 90-127[citado 9 mayo 2013]. Disponible en: http://www.sld.cu/sitios/ginecobs/temas.php?idl=163&idv=20059

22. Gómez Jiménez CA, Hernández Díaz M, Jiménez Cardoso J. Riesgo preconcepcional y métodos anticonceptivos de control. Revisión bibliográfica. Gaceta Médica Espirituana [Internet]. 2007 [citado 5 mayo 2013];9(1). Disponible en: http://www.bvs.sld.cu/revistas/gme/pub/vol.9.(1)_18/resumen.html

23. Organización Mundial de la Salud. Cuenta regresiva 2015. Informe del Decenio [Internet] Ginebra: Organización Mundial de la Salud; Diciembre 2010. [citado 5 mayo 2013]. Disponible en: http://www.apps.who.int/gb/ebwha/pdf_files/EB128/B128_35Add1-sp.pdf