Contribution of antepartum and intrapartum hemorrhage to the burden of maternal near miss and death in a national surveillance study

Abstract

Severe maternal outcome due to antepartum and intrapartum hemorrhage was highly prevalent among Brazilian women. Certain risk factors, maternal age and previous cesarean delivery in particular, were associated with the occurrence of bleeding.

Factors associated with maternal mortality among patients meeting criteria of severe maternal morbidity and near miss

“…A deficiency in prenatal care, which can lead to complications during pregnancy, is a reality in Brazil and has been reported in other studies. 10,13,14 Inthepresentstudy,568(64.5%)ofwomenwithsevere maternalmorbidityand54(88.5%)ofwomenwithnearmissordeath hadattendedfewerthansixprenatalappointments.…”

“…Second, the two study groups demonstrate clinical severity, which makesthemsimilartoacertainextent.Third,neitherthetimetaken before thesewomen received health care nor the therapeutic route leading to their admission was evaluated; these factors are known to be related to poorer maternal and neonatal results. [12][13][14][22][23][24] Additionally, data for newborns were missing from some medical records. The study has strengths.…”

Association between Maternal Mortality and Cesarean Section: Turkey Experience

“…However, a medically inappropriate CS is associated with a higher risk of perinatal and maternal mortality than is a vaginal delivery [1]. Studies have found that most cases of obstetric hemorrhage and emergency postpartum hysterectomy were associated with previousCSdeliveries [2]. Due to the surgical nature of CS, after controlling for indication bias and confounders, the risk of postpartummaternaldeath is almost three-fold higher than that associated with vaginal delivery; these maternal deaths are mainly due to postpartum hemorrhage and complications of anesthesia.…”

Severe obstetric morbidity (near miss)

“…A case of "Near miss maternal" is defi ned as the patient at risk of dying, but survives a complication that occurred during pregnancy, delivery or at the end of the puerperium or 42 days of termination of pregnancy; are those women who have survived life-threatening conditions (due to organic dysfunction). The indicators of processes are those that advise the mechanisms in the care of the health; The key to interventions related to the prevention and management of severe maternal complications will be used as a key to implement recommendations based on evidence [15,19].…”