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Contribution of antepartum and intrapartum hemorrhage to the burden of maternal near miss and death in a national surveillance study.
- Source :
-
Acta obstetricia et gynecologica Scandinavica [Acta Obstet Gynecol Scand] 2015 Jan; Vol. 94 (1), pp. 50-8. Date of Electronic Publication: 2014 Nov 11. - Publication Year :
- 2015
-
Abstract
- Objective: To evaluate the occurrence of severe obstetric complications associated with antepartum and intrapartum hemorrhage among women from the Brazilian Network for Surveillance of Severe Maternal Morbidity.<br />Design: Multicenter cross-sectional study.<br />Setting: Twenty-seven obstetric referral units in Brazil between July 2009 and June 2010.<br />Population: A total of 9555 women categorized as having obstetric complications.<br />Methods: The occurrence of potentially life-threatening conditions, maternal near miss and maternal deaths associated with antepartum and intrapartum hemorrhage was evaluated. Sociodemographic and obstetric characteristics and the use of criteria for management of severe bleeding were also assessed in these women.<br />Main Outcome Measures: The prevalence ratios with their respective 95% confidence intervals adjusted for the cluster effect of the design, and multiple logistic regression analysis were performed to identify factors independently associated with the occurrence of severe maternal outcome.<br />Results: Antepartum and intrapartum hemorrhage occurred in only 8% (767) of women experiencing any type of obstetric complication. However, it was responsible for 18.2% (140) of maternal near miss and 10% (14) of maternal death cases. On multivariate analysis, maternal age and previous cesarean section were shown to be independently associated with an increased risk of severe maternal outcome (near miss or death).<br />Conclusion: 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.<br /> (© 2014 Nordic Federation of Societies of Obstetrics and Gynecology.)
- Subjects :
- Adolescent
Adult
Brazil
Confidence Intervals
Cross-Sectional Studies
Delivery, Obstetric adverse effects
Delivery, Obstetric methods
Female
Hospitals, Maternity
Humans
Logistic Models
Maternal Mortality
Middle Aged
Multivariate Analysis
Obstetric Labor Complications economics
Pregnancy
Pregnancy Complications diagnosis
Prenatal Care
Risk Assessment
Severity of Illness Index
Socioeconomic Factors
Uterine Hemorrhage diagnosis
Uterine Hemorrhage economics
Young Adult
Cause of Death
Cost of Illness
Obstetric Labor Complications mortality
Pregnancy Complications epidemiology
Uterine Hemorrhage mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0412
- Volume :
- 94
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Acta obstetricia et gynecologica Scandinavica
- Publication Type :
- Academic Journal
- Accession number :
- 25327163
- Full Text :
- https://doi.org/10.1111/aogs.12529