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Background: Studies show that a large number of women around the world have experienced situations of abuse, disrespect, abuse, and neglect during childbirth and/or abortion. This violence is a serious violation of the rights of women, especially because it is a period in which the woman is more physiologically, socially, and psychologically vulnerable. Although this type of violence is known, there is still no international consensus on the definition of such violence and its prevalence is not known. In this sense, this systematic review aims (1) to find quantitative data about abuse and disrespect in obstetric care (delivery and/or abortion) in Latin America and the Caribbean to estimate the average prevalence of this type of abuse and (2) to identify interventions-including programs, laws, and regulations-which have been implemented to prevent or respond to abuse and disrespect in childbirth process and abortion situation, evaluating its effectiveness on a global scale., Methods: For this, we will use a refined and pre-established strategy to search databases such as PubMed, Embase, LILACS, and Scielo, and the studies found will pass through a selection process to complete the screening stage., Discussion: Data will be extracted using standardized forms with the following information: scope of study, sample characteristics, objectives, design, data collection, methods of analysis, data source, and results. Considering the heterogeneity of the definitions of abuse, disrespect, and mistreatment of women in labor or abortion, it may not be possible to carry out the meta-analysis of the frequency of events reported in the included articles. Events reported by the original articles will be classified according to a typology of abuse, disrespect, and maltreatment in the labor or abortion process described by Bohren et al. (PLoS Med, 2015)., Systematic Review Registration: PROSPERO CRD42016038651.

Background: There is a need for a clear and actionable definition of maternal sepsis, in order to better assess the burden of this condition, trigger timely and effective treatment and allow comparisons across facilities and countries. The objective of this study was to review maternal sepsis definitions and identification criteria and to report on the results of an expert consultation to develop a new international definition of maternal sepsis., Methods: All original and review articles and WHO documents, as well as clinical guidelines providing definitions and/or identification criteria of maternal sepsis were included. A multidisciplinary international panel of experts was surveyed through an online consultation in March-April 2016 on their opinion on the existing sepsis definitions, including new definition of sepsis proposed for the adult population (2016 Third International Consensus Definitions for Sepsis and Septic Shock) and importance of different criteria for identification of maternal sepsis. The definition was agreed using an iterative process in an expert face-to-face consensus development meeting convened by WHO and Jhpiego., Results: Standardizing the definition of maternal sepsis and aligning it with the current understanding of sepsis in the adult population was considered a mandatory step to improve the assessment of the burden of maternal sepsis by the expert panel. The literature review and expert consultation resulted in a new WHO consensus definition "Maternal sepsis is a life-threatening condition defined as organ dysfunction resulting from infection during pregnancy, child-birth, post-abortion, or post-partum period". Plans are in progress to validate the new WHO definition of maternal sepsis in a large international population., Conclusion: The operationalization of the new maternal sepsis definition requires generation of a set of practical criteria to identify women with sepsis. These criteria should enable clinicians to focus on the timely initiation of actionable elements of care (administration of antimicrobials and fluids, support of vital organ functions, and referral) and improve maternal outcomes.

Introduction: Women with postpartum haemorrhage (PPH) in developing countries often present in critical condition when treatment might be insufficient to save lives. Few studies have shown that application of non-pneumatic anti-shock garment (NASG) could improve maternal survival., Methods: A systematic review of the literature explored the effect of NASG use compared with standard care for treating PPH. Medline, EMBASE and PubMed were searched. Methodological quality was assessed following the criteria suggested by the Cochrane Effective Practice and Organization of Care Group. Guidelines on Meta-analysis of Observational Studies in Epidemiology were used for reporting the results. Mantel-Haenszel methods for meta-analysis of risk ratios were used., Results: Six out 31 studies met the inclusion criteria; only one cluster randomized controlled trial (c-RCT). Among observational studies, NASG fared better than standard care regarding maternal mortality reduction (Relative Risk (RR) 0.52 (95% Confidence interval (CI) 0.36 to 0.77)). A non-significant reduction of maternal mortality risk was observed in the c-RCT (RR: 0.43 (95% CI: 0.14 to 1.33)). No difference was observed between NASG use and standard care on use of blood products. Severe maternal outcomes were used as proxy for maternal death with similar pattern corroborating the trend towards beneficial effects associated with NASG., Conclusion: NASG is a temporizing alternative measure in PPH management that shows a trend to reduce PPH-related deaths and severe morbidities. In settings where delays in PPH management are common, particularly where constraints to offer blood products and definitive treatment exist, use of NASG is an intervention that should be considered as a policy option while the standard conditions for care are being optimized.