Mortality after near-miss obstetric complications in Burkina Faso: medical, social and health-care factors

Storeng, Katerini Tagmatarchi; Drabo, Seydou; Ganaba, Rasmané; Sundby, Johanne; Calvert, Clara; Filippi, Véronique

doi:10.2471/blt.11.094011

Cited by 55 publications

(61 citation statements)

References 28 publications

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“…29 Furthermore, as our study shows, the high expenses associated with emergency obstetric care can lead to serious long-lasting consequences that undermine the well-being of entire households, such as food insecurity, indebtedness and overall impoverishment. The high cost of treatment and the effort expended in coming up with the money hinder access to treatment and can result in delays that could prove fatal for the mother and the neonate.…”

Section: Resultsmentioning

confidence: 86%

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Emergency obstetric care in Mali: catastrophic spending and its impoverishing effects on households

Arsenault

Fournier

Philibert

et al. 2013

Bull. World Health Organ.

106

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Section: Resultsmentioning

confidence: 86%

“…Although the cause of her death is unknown, this case serves to illustrate that a woman being alive 42 days after a near-miss event is not a guarantee that a maternal death has been averted. 29 …”

Section: Resultsmentioning

confidence: 99%

Emergency obstetric care in Mali: catastrophic spending and its impoverishing effects on households

Arsenault

Fournier

Philibert

et al. 2013

Bull. World Health Organ.

106

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“…Many of the maternal morbidities and disabilities may arise during delivery, might appear any time within the subsequent six months, or could become chronic with worsening disability if not appropriately addressed [22,23,37,38]. The defining characteristics of ‘loss’ in ‘maternal near miss syndrome’ is psychological, social and biomedical, involving physical disruption, and loss of body image, social relations, livelihood and familiar patterns of life [39,40].…”

Section: Discussionmentioning

confidence: 99%

Lived experiences of women who developed uterine rupture following severe obstructed labor in Mulago hospital, Uganda

et al. 2014

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BackgroundMaternal mortality is a major public health challenge in Uganda. Whereas uterine rupture remains a major cause of maternal morbidity and mortality, there is limited research into what happens to women who survive such severe obstetric complications. Understanding their experiences might delineate strategies to support survivors.MethodsThis qualitative study used a phenomenological approach to explore lived experiences of women who developed uterine rupture following obstructed labor. In-depth interviews initially conducted during their hospitalization were repeated 3–6 months after the childbirth event to explore their health and meanings they attached to the traumatic events and their outcomes. Data were analyzed using thematic analysis.ResultsThe resultant themes included barriers to access healthcare, multiple “losses” and enduring physical, psychosocial and economic consequences. Many women who develop uterine rupture fail to access critical care needed due to failure to recognise danger signs of obstructed labor, late decision making for accessing care, geographical barriers to health facilities, late or failure to diagnose obstructed labor at health facilities, and failure to promptly perform caesarean section. Secondly, the sequel of uterine rupture includes several losses (loss of lives, loss of fertility, loss of body image, poor quality of life and disrupted marital relationships). Thirdly, uterine rupture has grim economic consequences for the survivors (with financial loss and loss of income during and after the calamitous events).ConclusionUterine rupture is associated with poor quality of care due to factors that operate at personal, household, family, community and society levels, and results in dire physical, psychosocial and financial consequences for survivors. There is need to improve access to and provision of emergency obstetric care in order to prevent uterine rupture consequent to obstructed labor. There is also critical need to provide counselling and support to survivors to enable them cope with physical, social, psychological and economic consequences.

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“…Timely identification and appropriate management of factors that increase the risk of progression from severe maternal morbidity to mortality have the potential to improve pregnancy care and to prevent deaths. Several previous studies have identified a number of factors that are thought to contribute to an increased risk of progression from severe maternal morbidity to death, such as delay in the identification of high‐risk status and inappropriate management and referral, inadequate antenatal care, and suboptimal clinical care during delivery and postpartum …”

Section: Introductionmentioning

confidence: 99%

Factors associated with maternal death from direct pregnancy complications: a UK national case–control study

Nair

Kurinczuk

Brocklehurst

et al. 2015

BJOG: Int J Obstet Gy

100

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ObjectiveTo investigate the factors associated with maternal death from direct pregnancy complications in the UK.DesignUnmatched case–control analysis.SettingAll hospitals caring for pregnant women in the UK.PopulationA total of 135 women who died (cases) between 2009 and 2012 from eclampsia, pulmonary embolism, severe sepsis, amniotic fluid embolism, and peripartum haemorrhage, using data from the Confidential Enquiry into Maternal Death, and another 1661 women who survived severe complications (controls) caused by these conditions (2005–2013), using data from the UK Obstetric Surveillance System.MethodsMultivariable regression analyses were undertaken to identify the factors that were associated with maternal deaths and to estimate the additive odds associated with the presence of one or more of these factors.Main outcome measuresOdds ratios associated with maternal death and population-attributable fractions, with 95% confidence intervals. Incremental risk of death associated with the factors using a ‘risk factors’ score.ResultsSix factors were independently associated with maternal death: inadequate use of antenatal care (adjusted odds ratio, aOR 15.87, 95% CI 6.73–37.41); substance misuse (aOR 10.16, 95% CI 1.81–57.04); medical comorbidities (aOR 4.82, 95% CI 3.14–7.40); previous pregnancy problems (aOR 2.21, 95% CI 1.34–3.62); hypertensive disorders of pregnancy (aOR 2.44, 95% CI 1.31–4.52); and Indian ethnicity (aOR 2.70, 95% CI 1.14–6.43). Of the increased risk associated with maternal death, 70% (95% CI 66–73%) could be attributed to these factors. Odds associated with maternal death increased by three and a half times per unit increase in the ‘risk factor’ score (aOR 3.59, 95% CI 2.83–4.56).ConclusionsThis study shows that medical comorbidities are importantly associated with direct (obstetric) deaths. Further studies are required to understand whether specific aspects of care could be improved to reduce maternal deaths among women with medical comorbidities in the UK.

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Mortality after near-miss obstetric complications in Burkina Faso: medical, social and health-care factors

Cited by 55 publications

References 28 publications

Emergency obstetric care in Mali: catastrophic spending and its impoverishing effects on households

Emergency obstetric care in Mali: catastrophic spending and its impoverishing effects on households

Lived experiences of women who developed uterine rupture following severe obstructed labor in Mulago hospital, Uganda

Factors associated with maternal death from direct pregnancy complications: a UK national case–control study

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