Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/201092
Type: Artigo de periódico
Title: Maternal Near Miss And Death Among Women With Severe Hypertensive Disorders: A Brazilian Multicenter Surveillance Study.
Author: Zanette, Elvira
Parpinelli, Mary Angela
Surita, Fernanda Garanhani
Costa, Maria Laura
Haddad, Samira Maerrawi
Sousa, Maria Helena
E Silva, Joao Luiz Pinto
Souza, Joao Paulo
Cecatti, Jose Guilherme
,
Abstract: Hypertensive disorders represent the major cause of maternal morbidity in middle income countries. The main objective of this study was to identify the prevalence and factors associated with severe maternal outcomes in women with severe hypertensive disorders. This was a cross-sectional, multicenter study, including 6706 women with severe hypertensive disorder from 27 maternity hospitals in Brazil. A prospective surveillance of severe maternal morbidity with data collected from medical charts and entered into OpenClinica®, an online system, over a one-year period (2009 to 2010). Women with severe preeclampsia, severe hypertension, eclampsia and HELLP syndrome were included in the study. They were grouped according to outcome in near miss, maternal death and potentially life-threatening condition. Prevalence ratios and 95% confidence intervals adjusted for cluster effect for maternal and perinatal variables and delays in receiving obstetric care were calculated as risk estimates of maternal complications having a severe maternal outcome (near miss or death). Poisson multiple regression analysis was also performed. Severe hypertensive disorders were the main cause of severe maternal morbidity (6706/9555); the prevalence of near miss was 4.2 cases per 1000 live births, there were 8.3 cases of Near Miss to 1 Maternal Death and the mortality index was 10.7% (case fatality). Early onset of the disease and postpartum hemorrhage were independent variables associated with severe maternal outcomes, in addition to acute pulmonary edema, previous heart disease and delays in receiving secondary and tertiary care. In women with severe hypertensive disorders, the current study identified situations independently associated with a severe maternal outcome, which could be modified by interventions in obstetric care and in the healthcare system. Furthermore, the study showed the feasibility of a hospital system for surveillance of severe maternal morbidity.
Subject: Adult
Brazil
Cross-sectional Studies
Female
Hospitals, Maternity
Humans
Hypertension, Pregnancy-induced
Maternal Mortality
Pregnancy
Pregnancy Complications
Rights: aberto
Identifier DOI: 10.1186/1742-4755-11-4
Address: http://www.ncbi.nlm.nih.gov/pubmed/24428879
Date Issue: 2014
Appears in Collections:Unicamp - Artigos e Outros Documentos

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