Changing trends in the Turkish maternal deaths, with a focus on direct and indirect causes

Engin-Üstün, Yaprak; Sanisoğlu, Sema; Keskin, Hüseyin Levent; Karaahmetoğlu, Selma; Özcan, Ayşe; Çelen, Şevki; Üstün, Yusuf; Alkan, Afra; Ongun, Veli; Şencan, İrfan

doi:10.1016/j.ejogrb.2018.12.031

Cited by 18 publications

(19 citation statements)

References 19 publications

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“…The WHO has initiated a process of agreeing on a definition and developing a uniform set of identification criteria for MNM cases, with the intent of facilitating reviews of these cases to monitor and improve the quality of obstetric care [10]. Our study showed the prevalence of MNM was 0.175% [25]. In sub-Saharan Africa, the MMR was 351 per 100,000 LBs, which was similar to that in south Asia (336 per 100,000 LBs) [26].…”

Section: Severe Maternal Outcomesmentioning

confidence: 76%

Epidemiology analysis of the incidence of severe maternal outcomes between level 2 and 3 hospitals in China’s Hunan province from 2012 to 2018

Liu

Xiong

Wang

et al. 2020

Preprint

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Background: This facility-based study analyzed the epidemiology and incidence of maternal near-miss (MNM) and mortality by hospital level as part of Hunan province’s efforts to raise the quality of hospital care for women. Methods: We used data for MNM and mortality cases for 2012–2018 from 17 hospitals (12 level 2 facilities, five level 3 facilities) that receive referrals for obstetric complications in Hunan province. Data were drawn from China’s National Maternal Near Miss Surveillance System, and collected using the World Health Organization near-miss tool. We calculated the ratio of severe maternal outcomes (SMO) (i.e., MNM and maternal death [MD] cases), mortality index (MI), and MNM to mortality ratio (MNM:MD), and epidemiological factors, organ dysfunction, and maternal complications stratified by hospital level. Chi-square tests to examine differences between groups and total ratios and 95% CI were calculated. Results: There were 518 SMO cases (489 MNM and 29 MD) among 279407 live births (LBs) and 1299 SMO cases(1262 MNM and 37 MD) among 232386 LBs in level 2 and 3 facilities. The total MNM ratio in level 2 and 3 hospitals was 1.75 (95%CI: 1.60–1.91) and 5.43 (95%CI: 5.14–5.74) per 1000 LBs, respectively. There were differences in SMO cases between level 2 and 3 hospitals in maternal age, education, parity, antenatal visits, and history of cesarean sections. In MNM cases, coagulation dysfunction was the main organ dysfunction (level 2 hospitals: 59.10%; level 3 hospitals: 79.32%), and the main maternal complications were obstetric hemorrhage (level 2 hospitals: 71.98%) and hepatopathy (level 3 hospitals: 69.49%). For MD cases, the main maternal complications were neurologic dysfunction (level 2 hospitals: 41.38%) and coagulation dysfunction (level 3 hospitals: 42.55%). Anemia was the main maternal complication for SMO cases in both level 2 (69.69%) and 3 (68.59%) hospitals. Conclusions: MNM and MD is higher in level 3 hospitals compared with level 2 hospitals. The obstetric emergency capacity of level 3 hospitals is higher than that of level 2 hospitals. Future government policies should consider upgrading the obstetric emergency treatment capacity in level 2 hospitals or to re-distinguish the social functions of different medical institutions.

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Section: Severe Maternal Outcomesmentioning

confidence: 76%

Epidemiology analysis of the incidence of severe maternal outcomes between level 2 and 3 hospitals in China’s Hunan province from 2012 to 2018

Liu

Xiong

Wang

et al. 2020

Preprint

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“…It has been reported that maternal mortality rate has been determined as 13.7 and 14.6 per 100.000 live births in 2015 and 2017, respectively, in Turkey [ 2 , 3 ]. Postpartum hemorrhage and maternal cardiovascular diseases were found to be most frequent reasons for maternal mortality in Turkey [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, maternal mortality is still a critical health issue in both low- and middle-income countries [ 1 ]. According to recent data, maternal mortality rate has been determined as 13.7 in 2015 and 14.6 in 2017 per 100.000 live births, respectively, in Turkey [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Maternal Mortality: 10 Year Experience of a Tertiary Center in Turkey

Fadıloğlu

Ünal

Öcal

et al. 2020

Case Reports in Medicine

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We retrospectively evaluated five maternal mortality cases that occurred in our institution within the last 10 years. Rate of maternal mortality was 24.5 per 100000 live births. Maternal mortality causes were cardiopulmonary failure secondary to veno-occlusive disease, septic shock secondary to osteosarcoma, pulmonary thromboembolism secondary to metastatic breast cancer, septic shock secondary to cholecystitis, and postpartum hemorrhage secondary to Niemann–Pick disease. Four out of five cases were evaluated as indirect maternal mortality cases. Three out of five cases ended up with a healthy newborn, while other cases ended up with abortus and postpartum exitus.

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“…2 The rate of maternal mortality in Turkey was 14.7 in 100 000 live births in 2015, and 14.2% of these deaths were caused by pre-eclampsia. 3 The majority of these deaths could have been prevented if necessary medical interventions and management had been realized appropriately and in a timely manner. 1,2 Nurses have a critical role in the management of pre-eclampsia, and it is essential that they have appropriate intervention skills.…”

Section: Introductionmentioning

confidence: 99%

“…Worldwide, pre‐eclampsia is the cause of 14.0% of maternal mortality 2 . The rate of maternal mortality in Turkey was 14.7 in 100 000 live births in 2015, and 14.2% of these deaths were caused by pre‐eclampsia 3 . The majority of these deaths could have been prevented if necessary medical interventions and management had been realized appropriately and in a timely manner 1,2…”

Section: Introductionmentioning

confidence: 99%

The impact of high‐fidelity simulation on knowledge, critical thinking, and clinical decision‐making for the management of pre‐eclampsia

Akalın

Şahin

2020

Intl J Gynecology & Obste

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Objective: To investigate the impact of high-fidelity simulation on nursing students' knowledge, critical thinking, and clinical decision-making in the management of preeclampsia, and to explore the students' views and learning experiences. Methods: A mixed-methods design study was conducted on 107 third-year nursing students. The students were randomly assigned to the control group (n=54) or the experimental group (n=53). The students in the experimental group attended the simulation training using a high-fidelity simulator, while the students in the control group attended only the classical training on "the management of pre-eclampsia." Results: Knowledge (P<0.001), critical thinking (P<0.05), and clinical decision-making (P<0.05) scores of students in the experimental group increased after the simulation. In the focus group interviews, five themes were identified: learning development; closing the gap between theory and practice; confident decision-making and self-confidence; professional preparation; and recommendations. Conclusion: High-fidelity simulation is efficacious for improving the management of pre-eclampsia among nursing students.

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Changing trends in the Turkish maternal deaths, with a focus on direct and indirect causes

Cited by 18 publications

References 19 publications

Epidemiology analysis of the incidence of severe maternal outcomes between level 2 and 3 hospitals in China’s Hunan province from 2012 to 2018

Epidemiology analysis of the incidence of severe maternal outcomes between level 2 and 3 hospitals in China’s Hunan province from 2012 to 2018

Maternal Mortality: 10 Year Experience of a Tertiary Center in Turkey

The impact of high‐fidelity simulation on knowledge, critical thinking, and clinical decision‐making for the management of pre‐eclampsia

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