Research on Severe Maternal Morbidities and Near-Misses in Brazil: What We Have Learned

Cecatti, José Guilherme; Souza, João Paulo; Parpinelli, Mary Ângela; Sousa, Maria Helena de; Amaral, Eliana

doi:10.1016/s0968-8080(07)30333-9

Cited by 52 publications

(45 citation statements)

References 23 publications

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“…It was also found that about one-third of them had attempted delivery assisted by a traditional birth attendant. Another study found that more than half of severe maternal morbidity was related to phase I delay [13]. The first delay is often discussed as a barrier to the healthcare facilities utilization.…”

Section: Delayed Decision To Seek Care (Phase 1)mentioning

confidence: 99%

“…It is a process depending on socioeconomic and cultural background, logistic and quality of care [11,18]. There are studies showing that women will only look for treatment when they had life threatening condition but some of them were not able to recognize the conditions [13,[19][20][21]. In a less developed countries, studies reported that fear of hospitals and lack of financial resourced to pay for transportation made them delaying the decision to go to the hospitals 17 .…”

Section: Delayed Decision To Seek Care (Phase 1)mentioning

confidence: 99%

“…Therefore in this discussion, the word perinatal near miss is used to refer the mother and the baby. Studies using maternal near miss are more accepted nowadays [13][14][15] as it is not as rare as maternal death. The FEMHEALTH project [16] has defined the health care near-miss as negative events or omissions which occurred in the process of care but which did not (necessarily) lead to serious harm.…”

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confidence: 99%

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Syndemic Approach in Preventing Perinatal Near Miss before First Phase of Three Delay Model

Sutan¹,

Yusof²

2017

IPCB

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Perinatal near miss covers the maternal and neonatal morbidity that refers to two targeted group of mother and baby. Maternal and perinatal mortality are two health indicators that showed very wide gaps of achievement by types of country based on income according to MDG achievement in 2015. The risk of a woman in a developing country dying from a maternal-related cause during her lifetime is much higher compared to a woman living in a developed country. Even though pattern of mortality shows declining trend in many countries, the MDG achievement has trigger more efforts to be geared and aligned. Researchers focus in assessing factors and determinant of maternal and perinatal mortality has shifted into severe morbidity cases or near miss cases. Many evaluation of obstetric care management based on the three delay model enable providers to identify points for improvement and has been mushrooming providing evidence based in scientific literature. However, where we need to focus for intervention and what kind of approaches is suitable is hardly seen published for our reference. Promoting wellbeing and ensure health are elements focussed in SDG provides ways in hindering health trajectory like perinatal near miss. However, the conceptualize approach needs to be narrated to the root of the problems. Evaluating evidence based medicine and scientific models help in generating solution on the root cause problem solving. Syndemic approach in designing preventive public health program targeting improving maternal and perinatal health is complex. It must involve pertinent component related to understanding on health seeking behaviour pattern, the monitoring and evaluation program based on log frame matrix analysis and understanding the dynamic of problem origin using three delay models.

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Section: Delayed Decision To Seek Care (Phase 1)mentioning

confidence: 99%

Section: Delayed Decision To Seek Care (Phase 1)mentioning

confidence: 99%

mentioning

confidence: 99%

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Syndemic Approach in Preventing Perinatal Near Miss before First Phase of Three Delay Model

Sutan¹,

Yusof²

2017

IPCB

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“…The Brazilian study showed a mortality rate of 260/100000 live births. [8][9][10] In other developing countries the maternal mortality ratios were in between 423/100000 live births to 324/100000 live births.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of associated risk factors of near miss obstetrics cases at B.P. Koirala Institute of Health Sciences, Dharan, Nepal

Khadka¹,

Uprety²,

Rai³

2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONWorldwide, more than half a million women between age 15-49 die each year from the complication of pregnancy and childbirth.1 Near misses have emerged as a useful complement to the investigation of maternal deaths. 2Near miss is defined as "A woman who nearly died but survived a complication that occurred during pregnancy, childbirth, or within 42 days of termination pregnancy. 2,3The patient survived either by chance or because of hospital care she received." Currently we have high pregnancy related mortality ratio (247 deaths due to any causes in pregnancy up to six weeks after pregnancy event per 100 thousand live births) and maternal mortality ratio (229 deaths due to pregnancy and childbirth related cause per 100 thousand live births) which constitutes 11% of deaths of women of reproductive age group.Various associated risk factors contribute to near miss events. Commonly seen in our context are: Antepartum/Postpartum hemorrhage, complication of abortion, ruptured ectopic and ruptured uterus, Hypertension complicating pregnancy: severe preeclampsia, eclampsia, sepsis or severe systemic ABSTRACT Background: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near miss obstetric cases. Methods: A prospective observational study was done from August 1, 2014 to July 30, 2015 in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by 5 factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, complication of abortion, ruptured uterus, medical/surgical condition and sepsis. Results: A total of 9,727 delivery were attended during the study period from August 2014 to July 2014. There were 6307 (71.5%) vaginal delivery and 2777 (28.5%) caesarean section and 181 perinatal death with total of 9,546 livebirth. 162 near miss and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions of 172, Severe maternal outcome ratio of 18.64, Maternal nearmiss: mortality ratio: 10.1:1, Mortality index: 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9% and cardiovascular and coagulation dysfunction as a major life-threatening condition and sepsis (25%) was the major cause of mortality. Conclusions: Haemorrhage and hypertensive disorders are the leading causes of near miss event. Evaluation of associated risk factor can be potential tool for reduction of maternal morbity and mortality.

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“…It is also clear that maternal death nearly are the tip of ice berg of maternal morbidity. High maternal mortality ratio may not allow detailed quantification of associated risk factor and determinants that are locally important .Underlying disease process of near miss and mortality were almost same so evaluation of circumstances surrounding near miss cases could act as proxy for maternal death 6 .…”

Section: Introductionmentioning

confidence: 99%

Maternal Near Miss : A Case Report

Noor

Hoque

Alam

et al. 2015

Chatt Maa Shi Hosp Med Coll J

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The term "Maternal Near Miss" (MNM) refer to women who have escaped death either by chance or due to good health care after experiencing severe life threatening complication during pregnancy, labour and within six weeks after termination of pregnancy. A "Near Miss" event in a 3 rd gravid at 42 weeks with intrauterine death having intractable Post Partum Haemorrhage (PPH) with severe maternal morbidity is reported here. Delay means death holds true for such emergency situation. The aim of the report is to stress the need of patients education, importance of emergency transportation and availability of multi-disciplinary tools and adequate blood transfusion at all level of health care system. Severe Acute Maternal Morbidity (SAMM) is a complement for maternal mortality and also to evaluate the quality of obstetric care in that particular institution.

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Research on Severe Maternal Morbidities and Near-Misses in Brazil: What We Have Learned

Cited by 52 publications

References 23 publications

Syndemic Approach in Preventing Perinatal Near Miss before First Phase of Three Delay Model

Syndemic Approach in Preventing Perinatal Near Miss before First Phase of Three Delay Model

Evaluation of associated risk factors of near miss obstetrics cases at B.P. Koirala Institute of Health Sciences, Dharan, Nepal

Maternal Near Miss : A Case Report

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