| Near-miss obstetrical events and maternal deaths. | |
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MedLine Citation:
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PMID: 20042157 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the frequency of near-miss cases, nature of near-miss events and mortality among obstetric patients. STUDY DESIGN: Cross-sectional, observational study. PLACE AND DURATION OF STUDY: The study was conducted in the Obstetric Unit of Fatima Hospital, Baqai Medical University, from January 2006 to December 2006. METHODOLOGY: Near-miss case definition was based on validated specific criteria comprising of five diagnostic features: haemorrhage, hypertensive disorders in pregnancy, dystocia, infection and anemia. The main outcome measures were frequency and characteristics of near-miss cases, total hospital stay, high dependency unit/ICU stay and development of multiple organ dysfunction. Near-miss events and maternal deaths were described with respect to disease profiles. Mortality indices were determined for various disease processes to appreciate the standard of care provided for near-miss cases. The maternal death to near-miss ratio was calculated. RESULTS: There were 868 deliveries in the year 2006, 44 near-miss cases, 47 near-miss events and 6 maternal deaths. The maternal death to near-miss ratio was 1:7. The most common type of near-miss events were obstetrical haemorrhage, anemia and dystocia responsible for 51%, 21.2% and 14.8% respectively. Severe hypertensive disorders in pregnancy and infections accounted for 8.5% and 4.2% of near-miss events. Postpartum haemorrhage was responsible for 83.3% and infection for 16.6% of the maternal deaths. The mortality index was higher for infections (33.3%) than for haemorrhage (17.2%). Organ system dysfunction/failure was diagnosed in 18.1% of near-miss cases. CONCLUSION: This study showed that for every 7 women who survived life threatening complications, one died. However, the underlying disease processes for near-miss and mortalities were almost same. Evaluation of the circumstances surrounding near miss cases could act as proxy for maternal deaths in the studied population. |
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Authors:
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Rozina Mustafa; Haleema Hashmi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP Volume: 19 ISSN: 1022-386X ISO Abbreviation: J Coll Physicians Surg Pak Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-31 Completed Date: 2010-04-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9606447 Medline TA: J Coll Physicians Surg Pak Country: Pakistan |
Other Details:
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Languages: eng Pagination: 781-5 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynaecology, Baqai Medical University, Karachi. roz_mustafa@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anemia / mortality Cross-Sectional Studies Female Humans Maternal Mortality Pakistan / epidemiology Pregnancy Pregnancy Complications / mortality* Pregnancy Complications, Hematologic / mortality Socioeconomic Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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