Between life and death: Women’s experiences of coming close to death, and surviving a severe postpartum haemorrhage and emergency hysterectomy

Elmir, Rakime; Schmied, Virginia; Jackson, Debra; Wilkes, Lesley M

doi:10.1016/j.midw.2010.11.008

Cited by 60 publications

(84 citation statements)

References 54 publications

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“…Sezaryen ya da travmatik doğumlar anne adayının kendisinin ve çocuğunun hayatının tehlikeye girdiğini algılamasına neden olarak psikolojik distress gibi birtakım negatif sonuçlar doğurabilir (20). Bu deneyimi yaşayan kişilerde stres, endişe, ölüm korkusu ve sonrasında posttravmatik stres bozukluğu ve PPD görülmektedir (20).…”

Section: Discussionunclassified

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Postpartum Depression and Associated Factors in Patients Who Admitted to Our Clinic to Make Child Birth

Demir¹,

Şentürk²,

Çakmak³

et al. 2016

Haseki

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Anahtar Sözcükler: Ekonomik durum, doğum, postpartum depresyon Aim:The aim of this study was to evaluate the incidence of postpartum depression (PPD) and associated factors in patients who have given birth in our clinic. Methods:This was a prospective controlled study including 482 cases. All the subjects were evaluated using the Beck depression inventory during antenatal period and those with a Beck depression inventory score of higher than 17 were excluded. Hence, we included 431 subjects. Age, duration and number of marriage, education level, economic status, personal factors as well as the factors associated with labor and newborn were investigated. These factors were compared between women with and without PPD by using Pearson's chi-square test. The factors which increased PPD were also investigated by using multivariate analysis. A p value of less than 0.05 was considered statistically significant.Results: PPD was observed in 34.8% of subjects (n=150). Previous marriage, continuous drug use and newborn taken to intensive care unit increased the incidence of PPD three times (p=0.003), 2.5 times (p=0.018), and 4.3 times (p=0.005), respectively. Conclusion:Economic, personal and labor-associated factors can increase PPD. These factors should be taken into consideration after birth and psychiatric consultation should be requested if necessary. Keywords: Economic status, birth, postpartum depression Abs tractYa z›fl maAd re si/Ad dressforCor res pon den ce:Mehmet Baki Şentürk Zeynep Kamil Eğitim ve Araştırma Hastanesi, Jinekoloji ve Obstetrik Kliniği, İstanbul, Türkiye

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Section: Discussionunclassified

“…Bu deneyimi yaşayan kişilerde stres, endişe, ölüm korkusu ve sonrasında posttravmatik stres bozukluğu ve PPD görülmektedir (20). Fakat bu çalışmamada annelerin %55,7'sinin normal doğum, %44,3'nün sezaryen yöntemi ile doğum yaptığı saptanmıştır.…”

Section: Discussionunclassified

Postpartum Depression and Associated Factors in Patients Who Admitted to Our Clinic to Make Child Birth

Demir¹,

Şentürk²,

Çakmak³

et al. 2016

Haseki

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“…[34][35][36][37][38] In addition to their physical recovery, women can experience anxiety, isolation and flashbacks in the aftermath. Birth trauma can have lasting consequences that impact negatively on maternal, infant and family well-being.…”

Section: Worktreamsmentioning

confidence: 99%

Beyond maternal death: improving the quality of maternal care through national studies of ‘near-miss’ maternal morbidity

Knight

Acosta

Brocklehurst

et al. 2016

Programme Grants Appl Res

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BackgroundStudies of maternal mortality have been shown to result in important improvements to women’s health. It is now recognised that in countries such as the UK, where maternal deaths are rare, the study of near-miss severe maternal morbidity provides additional information to aid disease prevention, treatment and service provision.ObjectivesTo (1) estimate the incidence of specific near-miss morbidities; (2) assess the contribution of existing risk factors to incidence; (3) describe different interventions and their impact on outcomes and costs; (4) identify any groups in which outcomes differ; (5) investigate factors associated with maternal death; (6) compare an external confidential enquiry or a local review approach for investigating quality of care for affected women; and (7) assess the longer-term impacts.MethodsMixed quantitative and qualitative methods including primary national observational studies, database analyses, surveys and case studies overseen by a user advisory group.SettingMaternity units in all four countries of the UK.ParticipantsWomen with near-miss maternal morbidities, their partners and comparison women without severe morbidity.Main outcome measuresThe incidence, risk factors, management and outcomes of uterine rupture, placenta accreta, haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, severe sepsis, amniotic fluid embolism and pregnancy at advanced maternal age (≥ 48 years at completion of pregnancy); factors associated with progression from severe morbidity to death; associations between severe maternal morbidity and ethnicity and socioeconomic status; lessons for care identified by local and external review; economic evaluation of interventions for management of postpartum haemorrhage (PPH); women’s experiences of near-miss maternal morbidity; long-term outcomes; and models of maternity care commissioned through experience-led and standard approaches.ResultsWomen and their partners reported long-term impacts of near-miss maternal morbidities on their physical and mental health. Older maternal age and caesarean delivery are associated with severe maternal morbidity in both current and future pregnancies. Antibiotic prescription for pregnant or postpartum women with suspected infection does not necessarily prevent progression to severe sepsis, which may be rapidly progressive. Delay in delivery, of up to 48 hours, may be safely undertaken in women with HELLP syndrome in whom there is no fetal compromise. Uterine compression sutures are a cost-effective second-line therapy for PPH. Medical comorbidities are associated with a fivefold increase in the odds of maternal death from direct pregnancy complications. External reviews identified more specific clinical messages for care than local reviews. Experience-led commissioning may be used as a way to commission maternity services.LimitationsThis programme used observational studies, some with limited sample size, and the possibility of uncontrolled confounding cannot be excluded.ConclusionsImplementation of the findings of this research could prevent both future severe pregnancy complications as well as improving the outcome of pregnancy for women. One of the clearest findings relates to the population of women with other medical and mental health problems in pregnancy and their risk of severe morbidity. Further research into models of pre-pregnancy, pregnancy and postnatal care is clearly needed.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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“…Any obstetric emergency is difficult (Beck, 2004;Mapp and Hudson, 2005;Ayers, 2007), but massive PPH with a new mother losing blood as fast as it is transfused is traumatic and frightening (Elmir et al, 2011;Snowdon et al, this issue). Most women would be incapacitated either by life-threatening blood loss or its treatment around the time of fulfilling trial entry criteria.…”

Section: Introductionmentioning

confidence: 99%

Views of emergency research (VERA): A qualitative study of women and their partners' views of recruitment to trials in severe postpartum haemorrhage

et al. 2012

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Between life and death: Women’s experiences of coming close to death, and surviving a severe postpartum haemorrhage and emergency hysterectomy

Cited by 60 publications

References 54 publications

Postpartum Depression and Associated Factors in Patients Who Admitted to Our Clinic to Make Child Birth

Postpartum Depression and Associated Factors in Patients Who Admitted to Our Clinic to Make Child Birth

Beyond maternal death: improving the quality of maternal care through national studies of ‘near-miss’ maternal morbidity

Views of emergency research (VERA): A qualitative study of women and their partners' views of recruitment to trials in severe postpartum haemorrhage

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