Document Detail


The paradox of obstetric "near misses": converting maternal mortality into morbidity.
MedLine Citation:
PMID:  18320871     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To systematically review evidence of obstetric near-misses and their consequences. DATA SOURCES: PUBMED, OVID, and references of retrieved articles were used. METHODS OF STUDY SELECTION: Only 13 original articles describe the occurrence of obstetric/maternal near-miss morbidity to date. All were included in this review, in addition to other articles related to the epidemiology and consequences of severe acute maternal morbidity. TABULATION, INTEGRATION, AND RESULTS: Serious forms of maternal morbidity occur in about 1% of women in the United States compared to 3.01 to 9.05% in some developing settings. Worldwide, the leading causes of near-miss morbidity are hemorrhage and pregnancy-related hypertension or eclampsia/pre-eclampsia. These complications can have lasting effects, and their sequelae may result in maternal illness, injury and disability. Based on severity, we have provided three phenotypes of obstetric near-misses: Class I (near-miss with healthy infant); Class II (near-miss with feto-infant morbidity); Class III (near-miss with fetal/infant death). CONCLUSION: Obstetric near-misses should be considered as potentially chronic illnesses that warrant follow-up care because the theoretical cycle of near-miss (as postulated in this paper) can only be interrupted by the resolution of residual issues or the mother's death. Some may consider near-miss events to be obstetric successes because ultimately the mother's life was spared, but the consequences of these complications can be overwhelming and enduring.
Authors:
Roneé E Wilson; Hamisu M Salihu
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  International journal of fertility and women's medicine     Volume:  52     ISSN:  1534-892X     ISO Abbreviation:  Int J Fertil Womens Med     Publication Date:    2007 Mar-Jun
Date Detail:
Created Date:  2008-03-06     Completed Date:  2008-04-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706778     Medline TA:  Int J Fertil Womens Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  121-7     Citation Subset:  IM    
Affiliation:
Department of Epidemiology and Biostatistics, University of South Florida, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Developing Countries
Emergency Medical Services / statistics & numerical data
Female
Humans
Maternal Health Services / methods*
Maternal Mortality*
Maternal Welfare / statistics & numerical data*
Obstetric Labor Complications / mortality*,  prevention & control
Pregnancy
Puerperal Disorders / mortality*,  prevention & control
Risk Factors
Socioeconomic Factors
United States
Women's Health*

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


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