Maternal near miss in obstetric critical care. Cartagena, Colombia, 2006 - 2008
DOI:
https://doi.org/10.18597/rcog.223Keywords:
pregnancy, intensive care, maternal mortality, morbidity, health status indicators, quality of health careAbstract
Objective: the present study aim to establish the incidence of severe maternal morbidity (SMM), the clinical characteristics and a first approximation to the quality indicators of the obstetric attention, of patients with SMM in the intensive care unit (ICU).
Materials and methods: a retrospective cohort study of all consecutive obstetric admissions to the intensive care unit (ICU) in the Rafael Calvo maternity clinic in Cartagena, Colombia from January 1, 2006 to December 31, 2008. Sociodemographic and obstetric data, severe maternal morbidity (SMM) criteria and indicators to monitor quality of obstetric care were registered. The statistical analysis utilized measures of central tendency and spread, percentages, frequency tables and Standardized Morbidity Ratio (SMR) with an interval confidence of 95% (CI 95%).
Results: the severe maternal morbidity incidence was 12.1 per 1000 deliveries. 27.2% of the population studied (88 patients) were teenagers and 61.6% were multiparous (199 patients). The most common diagnosis was hypertensive disorders of pregnancy (49.5%; 160 patients) followed by obstetric hemorrhages 22.6% (73 patients). The main dysfunctions were respiratory: 38.1% (123 patients), hepatic: 15.2% (49 patients) and immunological: 14.6% (47 patients). The most common intervention was transfusion, 22.6% (73 patients). During the study period the severe maternal morbidity incidence and the Maternal Near Miss mortality ratio increased, while the mortality index decreased.
Conclusions: the severe maternal morbidity incidence was 12.1 per 1000 deliveries. We present some quality of healthcare indicators in the obstetric patient as basal measurement that will serve for future comparisons.
Author Biographies
José A. Rojas
Marysabel Cogollo
Jezid E. Miranda
Enrique C. Ramos
Juan C. Fernández
Ana M. Bello
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