Document Detail


Maternal mortality and associated near-misses among emergency intrapartum obstetric referrals in Mulago Hospital, Kampala, Uganda.
MedLine Citation:
PMID:  12762430     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Many maternal deaths (as well as related severe morbidity) are of women who do not attend antenatal care in a given health unit but are referred there when they develop life-threatening obstetric complications. OBJECTIVE: To determine the reproductive characteristics of emergency obstetric referrals, and determine the contribution of emergency obstetric referrals to severe acute maternal morbidity (near-misses) and maternal mortality. STUDY DESIGN: Descriptive cross-sectional study. SETTING: Mulago hospital, the National Referral hospital, Kampala, Uganda, from 1st March to August 30th 2000. SUBJECTS: Nine hundred and eighty three consecutive women admitted as emergency obstetric referrals in labour or puerperium. INTERVENTIONS: Subjects were followed from time of admission to discharge (or death). They were interviewed (or examined) to obtain data on socio-demographic characteristics, reproductive history, obstetric outcome of the index pregnancy, obstetric complications and cause of death. Their records were reviewed to determine evidence of severe acute morbidity from acute organ/system dysfunction, using the definition by Mantel et al. These data were analysed using the Epilnfo computer programme in terms of means, frequencies and percentages. MAIN OUTCOME MEASURES: Socio-demographic characteristics, obstetric complications, cause of deaths, cause and type of near miss mortality and case fatality rates. RESULTS: Of the 983 referrals, over 100 were near-misses and 17 died. Using the definition of Mantel et al of near-misses enabled identification of six times as many near-misses as maternal deaths. The commonest causes of death were postpartum haemorrhage and eclampsia. Low status was highly associated with both maternal deaths and near misses. CONCLUSION: In developing countries, with poor obstetric services, emergency transfers in labour are very common. These women, who are of low status, contribute significantly to maternal mortality and morbidity.
Authors:
D Kaye; F Mirembe; F Aziga; B Namulema
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  East African medical journal     Volume:  80     ISSN:  0012-835X     ISO Abbreviation:  East Afr Med J     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-05-23     Completed Date:  2003-07-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372766     Medline TA:  East Afr Med J     Country:  Kenya    
Other Details:
Languages:  eng     Pagination:  144-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, Makerere University, P.O. Box 7072, Kampala, Uganda.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cross-Sectional Studies
Emergency Medical Services / statistics & numerical data*
Female
Health Knowledge, Attitudes, Practice
Humans
Maternal Mortality / trends*
Obstetric Labor Complications / mortality*
Obstetrics and Gynecology Department, Hospital / statistics & numerical data*
Parity
Pregnancy
Puerperal Disorders / mortality*
Referral and Consultation / statistics & numerical data
Socioeconomic Factors
Survival Analysis
Uganda / epidemiology
Women's Rights / statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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