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The Real Maternal Risks in a Pregnancy: A Structured Review to Enhance Maternal Understanding and Education
- Source :
- Journal of Obstetrics and Gynaecology Canada. 42:1364-1378.e7
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- This review sought to use high-level published data sources for system knowledge translation, collaborative enhanced maternal education and understanding, and prospective maternal quality and safety care planning. The goal was to answer the following question: What are the short- and long-term maternal risks (“near misses,” adverse events, severe morbidity and mortality) associated with pregnancy and childbirth? A structured analysis of the literature (systematic review, meta-analysis, observational case-control cohort), focusing on publications between 2016 and April 2019, was undertaken using the following key word search strategy: maternal, morbidity, mortality, co-morbidities (BMI, fertility, hypertension, cardiac, chronic renal disease, diabetes, mental health, stroke), preconception, antepartum, intrapartum, postpartum, “near miss,” and adverse events. Only large cohort database sources with control comparison studies were accepted for inclusion because maternal mortality events are rare. Systematic review and meta-analysis were not undertaken because of the wide clinical scope and the goal of creating an education algorithm tool. For this educational tool, the results were presented in a counselling format that included a control group of common maternal morbidity from a regional maternity cohort (2017) of 54 000 births and published risk estimates for pre-conception, pregnancy-associated comorbidity, pregnancy-onset conditions, long-term maternal health associations, and maternal mortality scenarios. Because issues related to maternal comorbidities are increasing in prevalence, personalized pre-conception education on maternal pregnancy risk estimates needs to be encouraged and available to promote greater understanding. This maternal morbidity and mortality evaluation tool allows for patient-provider review and recognition of the possible leading factors associated with an increased risk of maternal morbidity: pre-conception risks (maternal age >45 years; pre-existing cardiac or hypertensive conditions) and pregnancy-obstetrical risks (gestational hypertension, preeclampsia, eclampsia; caesarean delivery, whether preterm or term; operative vaginal delivery; maternal sepsis; placenta accreta spectrum; and antepartum or postpartum hemorrhage).
- Subjects :
- Counseling
Gestational hypertension
Health Knowledge, Attitudes, Practice
medicine.medical_specialty
Word search
03 medical and health sciences
0302 clinical medicine
Patient Education as Topic
Pregnancy
medicine
Humans
Childbirth
030212 general & internal medicine
030219 obstetrics & reproductive medicine
Eclampsia
Obstetrics
business.industry
Infant, Newborn
Pregnancy Outcome
Obstetrics and Gynecology
Middle Aged
medicine.disease
Comorbidity
Pregnancy Complications
Cohort
Female
Observational study
business
Maternal Age
Subjects
Details
- ISSN :
- 17012163
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Journal of Obstetrics and Gynaecology Canada
- Accession number :
- edsair.doi.dedup.....c36e5240e7237b9563e0eb23dfabf887