Extreme maternal morbidity in an intensive care unit

Authors

  • Julio Cesar González Aguilera Hospital General Universitario "Carlos Manuel de Céspedes" Bayamo. Granma.
  • Yoleinis Esperanza Esperanza Vázquez Belizón Hospital General Universitario “Carlos Manuel de Céspedes”, Bayamo, Granma.
  • Julia Matilde Pupo Jiménez Hospital General Universitario “Carlos Manuel de Céspedes”, Bayamo, Granma.
  • Luis Antonio Algas Hechavarría Centro Provincial de Información de Ciencias Médicas, Bayamo, Granma.
  • Jorge Omar Cabrera Lavernia Hospital General Universitario “Carlos Manuel de Céspedes”, Bayamo, Granma.

Keywords:

extreme maternal morbidity, maternal mortality, risk factors, indicators of extreme maternal morbidity, intensive care unit

Abstract

A cross-sectional study was carried out in the Intensive Care Unit of "Carlos Manuel de Céspedes" General University Hospital in Bayamo, Granma province from January, 2010 to December, 2014, in order to characterize the extreme maternal morbidity according to clinical and epidemiological variables.  From 504 assisted patients, 153 (30.3%) presented severe complications.  Hysterectomy due to infection and hemorrhages, circulatory shock, oxygen saturation under 90% and respiratory frequency higher than 40 or lower than 6 per minute constituted the fundamental indicators of extreme morbidity in these women.  The maternal morbidity and mortality rates were 11.1 per 100 00 live births and 5.6 per 1 000 live births, respectively.  Among the risk factors of extremely severe morbidity there were: gestacional age over 36 weeks, caesarean section and a history of this surgery.  

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Author Biography

Julio Cesar González Aguilera, Hospital General Universitario "Carlos Manuel de Céspedes" Bayamo. Granma.

Dcotor en Ciencias Médicas. Especialistas de II Grado en Medicina Intensiva y Emergencias y Medicina Interna. Profesor titular.

References

1. Litorp H, Kidanto HL, Rööst M, Abeid M, Nyström L, B Essén. Maternal near-miss and death and their association with caesarean section complications: a cross-sectional study at a university hospital and a regional hospital in Tanzania. BMC Pregnancy Childbirth. 2014 [citado 18 Sep 2015]; 14(1). Disponible en: http://www.biomedcentral.com/1471-2393/14/244

2. Lotufo FA, Parpinelli MA, Haddad SM, Surita FG, Cecatti JG. Applying the new concept of maternal near-miss in an intensive care unit. Clinics (Sao Paulo). 2012 [citado 18 Sep 2015]; 67(3). Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3297030/

3. Chhabra P. Maternal near miss: an indicator for maternal health and maternal care. Indian J Community Med. 2014 [citado 18 Sep 2015]; 39(3). Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4134527/

4. Say L, Pattinson RC, Gülmezoglu AM. WHO systematic review of maternal morbidity and mortality: the prevalence of severe acute maternal morbidity (near miss). Reprod Health. 2004 [citado 18 Ene 2015 ];1(1). Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC516581/

5. Tunçalp O, Hindin MJ, Souza JP, Chou D, Say L. The prevalence of maternal near miss: a systematic review. BJOG. 2012 [citado 18 Sep 2015 ]; 119(6). Disponible en: http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2012.03294.x/full

6. Say L, Souza JP, Pattinson RC; WHO working group on Maternal Mortality and Morbidity classifications. Maternal near miss--towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clin Obstet Gynaecol. 2009; 23(3): 287-96.

7. Álvarez M. Morbilidad materna extremadamente grave. Generalidades. En: La Morbilidad maternal extremadamente grave, un reto actual para la reducción de la mortalidad materna. La Habana: Molinos Trade; 2012. p.13-23.

8. Kaye DK, Kakaire O, Osinde MO. Systematic review of the magnitude and case fatality ratio for severe maternal morbidity in sub-Saharan Africa between 1995 and 2010. BMC Pregnancy and Childbirth. 2011 [citado 18 Sep 2015 ];11. Disponible en: http://www.biomedcentral.com/1471-2393/11/65

9. Wanderer JP, Leffert LR, Mhyre JM, Kuklina EV, Callaghan WM, Bateman BT. Epidemiology of obstetric-related UCI admissions in Maryland: 1999–2008. Crit Care Med. 2013 [citado 18 Sep 2015 ]; 41(8). Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23648568

10. Rojas JA, Cogollo M, Miranda JE, Ramos EC, Fernández JC, Bello AM. Morbilidad materna extrema en cuidados intensivos obstétricos. Cartagena (Colombia) 2006-2008. Rev Colomb Obst Ginecol. 2011 [citado 18 Sep 2015]; 62(2). Disponible en: http://www.scielo.org.co/pdf/rcog/v62n2/v62n2a03.pdf

11. Oliveira LC, Costa AA. Maternal near miss in the intensive care unit: clinical and epidemiological aspects. Rev Bras Ter Intensiva. 2015 [citado 18 Sep 2015 ]; 27(3). Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/26270856

12. Correira AJ, Katz L, Rolland AS, Ramos MM. Factors associated with severe maternal morbidity and near miss in the São Francisco Valley, Brazil: a retrospective, cohort study. BMC Pregnancy and Childbirth. 2014 [citado 18 Sep 2015];14. Disponible en: http://www.biomedcentral.com/1471-2393/14/91

13. Rulisa S, Umuziranenge I, Small M, van Rossmalen J. Maternal near miss and mortality in tertiary care hospital in Rwanda. BMC Pregnancy and Childbirth. 2015 [citado 18 Sep 2015];15. Disponible en: http://www.biomedcentral.com/1471-2393/15/203

14. Adeoye IA, Ijarotimi OO, Fatusi AO. What are the factors that interplay from normal pregnancy to near miss maternal morbidity in a Nigerian tertiary health care facility? Health Care for Women International. 2015 [citado 18 Sep 2015]; 36. Disponible en: http://www.tandfonline.com/doi/pdf/10.1080/07399332.2014.943839

15. Van den Akker T, Beltman J, Leyten J, Mwagomba B, Meguid T. The WHO maternal near miss approach: Consequences at Malawian District level. PLoS ONE. 2013 [citado 18 Sep 2015]; 8. Disponible en: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0054805

Published

2015-12-12

How to Cite

1.
González Aguilera JC, Vázquez Belizón YEE, Pupo Jiménez JM, Algas Hechavarría LA, Cabrera Lavernia JO. Extreme maternal morbidity in an intensive care unit. MEDISAN [Internet]. 2015 Dec. 12 [cited 2025 Jun. 3];19(12). Available from: https://medisan.sld.cu/index.php/san/article/view/598

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Section

Original Articles