medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2020, Number 09

<< Back Next >>

Ginecol Obstet Mex 2020; 88 (09)

Maternal Near-Miss: Indicators and medicalsurgical interventions carried out to avoid maternal death

Nava-Guerrero EN, Nungaray-González L, Salcedo-González A, Cisneros-Rivera F, Perales-Dávila J, Durán-Luna A

Language: Spanish
References: 20
Page: 606-614
PDF size: 219.35 Kb.


ABSTRACT

Objective: To classify extreme maternal morbidity according to the indicators proposed by the World Health Organization and to establish its prevalence in a second level hospital in northern Mexico. In addition, describe the medical-surgical interventions carried out to prevent maternal death.
Materials and Methods: Observational, cross-sectional and retrospective study of a series of cases of extreme maternal morbidity (treated between January 2015 and December 2018) that met the life-threatening conditions defined by the WHO. The information was obtained from the electronic file. Descriptive statistical analysis was carried out using central tendency measures.
Results: There were 59,481 live births, including 2792 cases that met the inclusion criteria for extreme maternal morbidity. Eighty-six cases were eliminated due to incomplete information in the file. A total of 2706 cases of extreme maternal morbidity were analyzed, representing a prevalence of 4.5%, with an extreme maternal morbidity ratio of 45.49 per 1000 live births. Four cases of maternal death were recorded, representing a maternal death ratio of 6.7 per 100,000 live births.
Conclusion: The prevalence of extreme maternal morbidity was lower than reported in Latin American countries and higher than in developed countries. There is an upward trend in the frequency of extreme maternal morbidity where hypertensive disorders are the most related life-threatening cause and sepsis has the highest mortality rate.


REFERENCES

  1. Souza JP, et al. Maternal near miss and maternal death in the World Health Organization’s 2005 global survey on maternal and perinatal health. Bull World Health Organ. 2010; 88 (2): 113-19. doi: 10.2471/BLT.08.057828

  2. Say L, et al. WHO systematic review of maternal morbidity and mortality: the prevalence of severe acute maternal morbidity (near miss). Reprod Health. 2004; 1 (1): 3. doi:10.1186/1742-4755-1-3

  3. Say L, et al. Maternal near miss--towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clin Obstet Gynaecol. 2009; 23 (3): 287-96. doi:10.1016/j. bpobgyn.2009.01.00

  4. Chou D, et al. Maternal Morbidity Working Group. Constructing maternal morbidity - towards a standard tool to measure and monitor maternal health beyond mortality. BMC Pregnancy Childbirth. 2016; 16:45. https://doi. org/10.1186/s12884-015-0789-4

  5. World Health Organization. Evaluating the quality of care for severe pregnancy complications The WHO near-miss approach for maternal health. 2011. https://apps.who.int/ iris/bitstream/handle/10665/44692/9789241502221_eng. pdf;jsessioni d=B0A022828759F7C924B0180559FF1B45? sequence=1>

  6. Geller SE, et al. The continuum of maternal morbidity and mortality: factors associated with severity. Am J Obstet Gynecol. 2004; 191 (3): 939-44. doi:10.1016/j. ajog.2004.05.099

  7. Esparza-Valencia DM, et al. Prevalencia de morbilidad materna extrema en un hospital de segundo nivel de San Luis Potosí, México. Ginecol Obstet Mex. 2018; 86 (5): 304-12. doi: https://doi.org/10.24245/gom. v86i5.1931.

  8. Calvo-Aguilar O, et al. Morbilidad materna extrema en el Hospital General Dr. Aurelio Valdivieso, Servicios de Salud de Oaxaca. Ginecol Obstet Mex. 2010; 78 (12): 660-68.

  9. Tunçalp O, et al. The prevalence of maternal near miss: a systematic review. BJOG. 2012; 119 (6): 653-61. doi:10.1111/j.1471-0528.2012. 03294.x

  10. De Mucio B, et al. Maternal near miss and predictive ability of potentially life-threatening conditions at selected maternity hospitals in Latin America. Reprod Health. 2016; 13 (1): 134. doi:10.1186/s12978-016-0250-9.

  11. World Health Organization. Trends in Maternal Mortality. 2000 to 2017. Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. http://documents. worldbank.org/curated/en/793971568908763231/ pdf/Trends-in-maternal-mortality-2000-to-2017-Estimatesby- WHO-UNICEF-UNFPA-World-Bank-Group-and-the-United- Nations-Population-Division.pdf

  12. Indicadores 2015. Mortalidad Materna en México by Observatorio de Mortalidad en México, 1ª ed. 2018. http:// www.omm.org.mx/images/stories/Documentos%20 grandes/Indicadores_2015.pdf

  13. Burton GJ, et al. Pre-eclampsia: pathophysiology and clinical implications. BMJ. 2019; 366: 12381. doi:10.1136/ bmj. l2381

  14. Say L, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014; 2 (6): e323-e333. doi:10.1016/S2214-109X (14)70227-X

  15. American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013; 122 (5): 1122-1131. doi: 10.1097/01.AOG.0000437382.03963.88

  16. Calvert C, et al. Identifying regional variation in the prevalence of postpartum haemorrhage: a systematic review and meta-analysis. PLoS One. 2012; 7 (7): e41114. doi: 10.1371/journal.pone.0041114.

  17. Westhoff G, et al. Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage. Cochrane Database Syst Rev. 2013; (10): CD001808. doi: 10.1002/14651858.CD001808.pub2.

  18. Mavrides E, et al. Prevention and management of postpartum haemorrhage. BJOG 2016; doi.10.1111/1471- 0528.14178.

  19. Himes KP, Bodnar LM. Validation of criteria to identify severe maternal morbidity. Paediatr Perinat Epidemiol 2020; 17. doi: 10.1111/ppe.12610.

  20. Main EK, et al. Measuring severe maternal morbidity: validation of potential measures. Am J Obstet Gynecol. 2016; 214 (5): 643.e1-643.e10. doi. 10.1016/j. ajog.2015.11.004




2020     |     www.medigraphic.com