| Maternal mortality and associated near-misses among emergency intrapartum obstetric referrals in Mulago Hospital, Kampala, Uganda. | |
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MedLine Citation:
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PMID: 12762430 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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D Kaye; F Mirembe; F Aziga; B Namulema |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: East African medical journal Volume: 80 ISSN: 0012-835X ISO Abbreviation: East Afr Med J Publication Date: 2003 Mar |
Date Detail:
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Created Date: 2003-05-23 Completed Date: 2003-07-01 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372766 Medline TA: East Afr Med J Country: Kenya |
Other Details:
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Languages: eng Pagination: 144-9 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynaecology, Makerere University, P.O. Box 7072, Kampala, Uganda. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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