| Applying the new concept of maternal near-miss in an intensive care unit. | |
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MedLine Citation:
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PMID: 22473402 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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 their outcomes: 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. |
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Authors:
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Fátima Aparecida Lotufo; Mary Angela Parpinelli; Samira Maerrawi Haddad; Fernanda Garanhani Surita; Jose Guilherme Cecatti |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinics (São Paulo, Brazil) Volume: 67 ISSN: 1980-5322 ISO Abbreviation: Clinics (Sao Paulo) Publication Date: 2012 |
Date Detail:
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Created Date: 2012-04-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101244734 Medline TA: Clinics (Sao Paulo) Country: Brazil |
Other Details:
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Languages: eng Pagination: 225-30 Citation Subset: IM |
Affiliation:
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University of Campinas, Campinas, SP, Brazil. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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