Souza et al.99 Souza JPD, Cecatti JG, Parpinelli MA. Fatores associados à gravidade da morbidade materna na caracterização do near miss. Rev Bras Ginecol Obstet. 2005; 27 (4): 197-203. 2005 |
Campinas, Sao Paulo |
From July 2003 until June 2004 |
-Case-control -Bivariate analysis |
- 1 24 women with severe maternal morbidity at a University maternity |
-Mantel et al.3232 Mantel GD, Buchmann E, Rees H, Pattinson RC. Severe acute maternal morbidity: a pilot study of a definition for a near miss. Br J Obstet Gynaecol. 1998; 105 (9): 985- 90. or Waterstone et al.3131 Waterstone M, Bewley S, Wolfe C. Incidence and predic-tors of severe obstetric morbidity: case-control study. BMJ. 2001;322(7294):1089-93. -Additional: Geller et al.3333 Geller SE, Rosenberg D, Cox SM, Kilpatrick S. Defining a conceptual framework for near miss maternal morbidity. J Am Med Womens Assoc. 2002; 57 (3): 135-9.
|
-Severe maternal morbidity (SMM): 124 cases (Mantel or Waterstone criteria). SMM ratio: 42/1,000 childbirths -Near miss ratio (Geller3333 Geller SE, Rosenberg D, Cox SM, Kilpatrick S. Defining a conceptual framework for near miss maternal morbidity. J Am Med Womens Assoc. 2002; 57 (3): 135-9. criteria): 6,8/1,000 childbirths; 20 women with very severe maternal morbidity (Cases) and 104 controls "with others severe morbidities" (Control) - Previous abortion was the only association with SMM (OR=3.41 ; 95%CI=1.08-10.79). -Hypertension was the only clinical condition most frequent for SMM, while hemorrhage predominated on the near miss group |
Souza et al.1010 Souza JP, Cecatti JG, Parpinelli MA, Serruya SJ, Amaral E. Appropriate criteria for identification of near miss maternal morbidity in tertiary care facilities: a cross sectional study. BMC Pregnancy Childbirth. 2007; 11 (7): 20. 2007 |
Campinas, Sao Paulo |
From July 2003 until June 2004 |
-Cross-sectional descriptive -Daily visits: delivery rooms, ICU, Ward. Review on medical files after hospital leave. |
- 2929 childbirths in a university maternity |
-Mantel et al.3232 Mantel GD, Buchmann E, Rees H, Pattinson RC. Severe acute maternal morbidity: a pilot study of a definition for a near miss. Br J Obstet Gynaecol. 1998; 105 (9): 985- 90. or Waterstone et al.3131 Waterstone M, Bewley S, Wolfe C. Incidence and predic-tors of severe obstetric morbidity: case-control study. BMJ. 2001;322(7294):1089-93.
|
-Total: 124 cases of SMM (SMM ratio= 42/1000 childbirths). - 2 maternal deaths. MNM/MD ratio 62 - Waterstone's criteria= 86 (SMM ratio = 38/1000), which preeclampsia was the most frequent; - Mantel's criteria= 62 (SMM ratio= 31/1000), which ICU admission was the most frequent - Most common conditions= Hypertension (57.3%), non-obstetrics (21%) and hemorrhage (13.7%) |
Amorim et al.1111 Amorim MM, Katz L, Valença M, Araújo DE. Morbidade materna grave em UTI obstétrica no Recife, região nordeste do Brasil. Rev Assoc Med Bras. 2008; 54 (3): 261-6. 2008 |
Recife, Pernambuco |
2003-2007 |
-Cross-sectional descriptive -Review on medical files |
- 291 women with near miss criterion admitted in the obstetrics ICU |
-Mantel et al.3232 Mantel GD, Buchmann E, Rees H, Pattinson RC. Severe acute maternal morbidity: a pilot study of a definition for a near miss. Br J Obstet Gynaecol. 1998; 105 (9): 985- 90.
|
- Of the 291= hypertension (78.4%) was the main cause for admission, followed by hemorrhage - Most common clinical diseases: heart diseases (5.8%), chronic arterial hypertension (5.1%), chronic liver diseases (3%) and diabetes mellitus (2.4%) - Eclampsia was present in 38.8%, HELLP syndrome in 28,2% and hemorrhagic shock in 27.1% of the patients - Most common invasive procedures: blood transfusion (36%), profound venous puncture (13.4%), vasoactive drugs (1 0.8%) and assisted mechanical ventilation (9.1%) |
Luz et al. 1212 Luz AG, Tiago DB, Silva JC, Amaral E. Severe maternal morbidity at a local reference university hospital in Campinas, São Paulo, Brazil. Rev Bras Ginecol Obstet. 2008; 30 (6): 281-6. 2008 |
Campinas, Sao Paulo |
2005-2006 |
-Cross-sectional -Review on medical files -Non-adjusted prevalence ratio |
- 2207 childbirths - 1 1 4 women with SMM |
-Mantel et al.3232 Mantel GD, Buchmann E, Rees H, Pattinson RC. Severe acute maternal morbidity: a pilot study of a definition for a near miss. Br J Obstet Gynaecol. 1998; 105 (9): 985- 90.
-Waterstone et al.3131 Waterstone M, Bewley S, Wolfe C. Incidence and predic-tors of severe obstetric morbidity: case-control study. BMJ. 2001;322(7294):1089-93.
|
- SMM = 114 cases (15 of extremely severe morbidity ESMM and 99 of other morbidities) - ESMM rate= 6.8/1,000 childbirths; Rate of others maternal morbidities= 44.9/1,000 childbirths - Most common conditions of ESMM= post-childbirth hemorrhage (46.7%), insufficiency respiratory (13.4%), hypertension (13.3%) and pre-childbirth hemorrhage (13.3%); without any association with the variables in the study |
Oliveira-Neto et al.,1313 Oliveira Neto AF, Parpinelli MA, Cecatti JG, Souza JP, Sousa MH. Factors associated with maternal death in women admitted to an intensive care unit with severe maternal morbidity. Int J Gynaecol Obstet. 2009; 105 (3): 252-6. 2009 |
Campinas, Sao Paulo |
2002-2007 |
-Retrospective cohort -Bivariate analysis |
- 673 women in the ICU obstetric at the University maternity |
-ICU admission |
- Of the 673 women, 18 cases of MD and 655 of SMM. - SMM ratio = 46.6/1,000 LB; MMR=124/100,000 LB -Causes of MNM and SMM/MD ratio= Hypertension: 322 cases, ratio 321:1 / Hemorrhage: 92 cases, ratio 30:1 / Infections: 17 cases, ratio 6:1 Non-obstetrics: 230 cases, ratio 25:1 -Interventions/procedures associated to death: reanimation, mechanical ventilation, vasoactive drugs use, cardioversion, blood transfusion |
Amaral et al.,1414 Amaral E, Souza JP, Surita F, Luz AG, Sousa MH, Cecatti JG, Campbell O. A population-based surveillance study on severe acute maternal morbidity (near miss) and adverse perinatal outcomes in Campinas, Brazil: the Vigimoma Project. BMC Pregnancy Childbirth. 2011; 11:9. 2011 |
Campinas, Sao Paulo |
From October 2005 until December 2005 |
-Cross-sectional descriptive -Daily collection of medical files and hospital registration -MD committee evaluation |
-All cases of severe acute maternal morbidity/ near miss in the city. - 4,491 live births |
-Mantel' et al.3232 Mantel GD, Buchmann E, Rees H, Pattinson RC. Severe acute maternal morbidity: a pilot study of a definition for a near miss. Br J Obstet Gynaecol. 1998; 105 (9): 985- 90. adapted criteria -Waterstone et al.3131 Waterstone M, Bewley S, Wolfe C. Incidence and predic-tors of severe obstetric morbidity: case-control study. BMJ. 2001;322(7294):1089-93.
|
- MNM total cases= 95 / Maternal death total = 4 MNM ratio= 21.2/1,000 live births MNM/MD ratio= 23.7:1; mortality rate= 4.04% - Causes= hypertension diseases (57.8%); post-childbirth hemorrhage (17.9%) - Delays for care= 34% of the cases (most frequent after admission in maternities, in relation to management, like the use of magnesium sulfate and post-childbirth hemorrhage prophylaxis) |
Morse et al.,1515 Morse ML, Fonseca SC, Gottgtroy CL, Waldmann CS, Gueller E. Morbidade Materna Grave e Near Miss em Hospital de Referência Regional. Rev Bras Epidemiol. 2011; 14 (2): 310-22. 2011 |
Niteroi, Estado do Rio de Janeiro |
2009 |
-Cross-sectional descriptive -Review on medical files |
- 1.554 childbirths in a referral public maternity hospital for, high-risk in the metropolitan region II of Rio de Janerio |
-Mantel et al.3232 Mantel GD, Buchmann E, Rees H, Pattinson RC. Severe acute maternal morbidity: a pilot study of a definition for a near miss. Br J Obstet Gynaecol. 1998; 105 (9): 985- 90.
-Waterstone et al.3131 Waterstone M, Bewley S, Wolfe C. Incidence and predic-tors of severe obstetric morbidity: case-control study. BMJ. 2001;322(7294):1089-93. -WHO33 Organização Mundial de Saúde. Avaliação da Qualidade do Cuidado nas Complicações Graves da Gestação: A Abordagem do Near Miss da OMS para a Saúde Materna. Uruguay. OMS; 2011.
|
- MNM cases, considering any criteria: 89 cases; by WHO criteria, 10 cases. Three cases of MD - MNMR= - WHO - 9.4/1,000 live births; Waterstone - 81.4/1,000 live births; - Mantel - 13.1/1,000 live births -Mortality rate (WHO) = 23%; MNM/MD ratio = 3.3 Most frequent markers were: severe preeclampsia (68.5%), severe hemorrhage (19.1%) and ICU admission (10.1%) |
Moraes et al.,1616 Moraes AP, Barreto SM, Passos VM, Golino PS, Costa JA, Vasconcelos MX. Incidence and main causes of severe maternal morbidity in São Luís, Maranhão, Brazil: a longitudinal study. São Paulo Med J. 2011; 129 (3): 146-52. 2011 |
Sao Luiz, Maranhao |
2009-2010 |
-Longitudinal descriptive -Search on medical files and interviews with health professionals at the health units -Fisher test, χ2, t -Stude nt tes t a nd Mann-Whitney |
- 8493 childbirths |
-Mantel et al.3232 Mantel GD, Buchmann E, Rees H, Pattinson RC. Severe acute maternal morbidity: a pilot study of a definition for a near miss. Br J Obstet Gynaecol. 1998; 105 (9): 985- 90.
-Waterstone et al.3131 Waterstone M, Bewley S, Wolfe C. Incidence and predic-tors of severe obstetric morbidity: case-control study. BMJ. 2001;322(7294):1089-93.
|
- 127 women presented one of the analyzed criteria -Incidence rate of severe maternal morbidity= Total: 15/1,000 childbirths; Waterstone: 14.1/1,000 childbirths Mantel: 3.4/1,000 childbirths - At admission, 84% of the women presented hypertension disorders, 11.4% hemorrhagic disorders, 2.5% infected abortion and 1.6% other causes -Significant association with ESMM cases: longer hospitalization time (p-value = <0.001) e hemorrhage (p-value = <0.01) |
Lotufo et al.,1717 Lotufo FA, Parpinelli MA, Haddad SM, Surita FG, Cecatti JG. Applying the new concept of maternal near miss in an intensive care unit. Clinics. 2012; 67 (3): 225-30. 2012 |
Limeira, Sao Paulo |
2004-2007 |
-Cross-sectional -Multivariate regression |
- 158 wo men a d m it-ted at an obstetric ICU at a general teaching hospital |
-WHO33 Organização Mundial de Saúde. Avaliação da Qualidade do Cuidado nas Complicações Graves da Gestação: A Abordagem do Near Miss da OMS para a Saúde Materna. Uruguay. OMS; 2011.
-ICU admission |
ICU admission immediately after childbirth (87%) - From the total, 5 MD, 43 MNM, 110 PLTC - MNM ratio= 4.4/1,000 live births; Mortality rate=10.6% (higher for clinical-surgical conditions and infections) - MNM/MD= 8.6 - Most common management criteria, outlining vasoactive drugs, hysterectomy and blood transfusion; among the laboratory, the PaO2/Fio2<200 ratio was the most present and, among the clinical criteria, shock. - The only association between MNM and MD: cesarean section (OR=0.03; CI=0.002-0.49) |
Moraes et al.,1818 Moraes APP, Barreto SM, Passos VM a, Golino PS, Costa JE, Vasconcelos MX. Severe maternal morbidity: a case-control study in Maranhão, Brazil. Reprod Health. 2013; 10:11. 2013 |
Sao Luiz, Maranhao |
2009-2010 |
-Case-control -Health professionals' report |
-Two high-risk maternities and two referral obstetric ICU - 122 MNM cases at the ICU and 244 controls (maternities) |
-Mantel et al.3232 Mantel GD, Buchmann E, Rees H, Pattinson RC. Severe acute maternal morbidity: a pilot study of a definition for a near miss. Br J Obstet Gynaecol. 1998; 105 (9): 985- 90.
-Waterstone et al.3131 Waterstone M, Bewley S, Wolfe C. Incidence and predic-tors of severe obstetric morbidity: case-control study. BMJ. 2001;322(7294):1089-93.
|
Total of cases: 122 - 66.4% presented severe pre-eclampsia, 11.5% eclampsia, 11.4% obstetric hemorrhage, 5.7% HELLP syndrome, 2.5% infected abortion, 1.6% preeclampsia overlapped chronic hypertension and 1.6% obstetrics complications - Statistically significant association with SMM: age ≥35 years old (OR=3.11), previous hypertension (OR=2.52), < 4 prenatal consultations (OR=1.89) |
Lobato et al.,1919 Lobato G, Nakamura-Pereira M, Mendes-Silva W, Dias MAB, Reichenheim ME. Comparing different diagnostic approaches to severe maternal morbidity and near miss: a pilot study in a Brazilian tertiary hospital. Eur J Obstet Gynecol Reprod Biol. 2013; 167 (1): 24-8. 2013 |
Rio de Janeiro, Estado do Rio de Janeiro |
2008 |
-Cross-sectional descriptive -Review on medical files |
- 1,163 women in University maternity hospital |
-Waterstone et al.3131 Waterstone M, Bewley S, Wolfe C. Incidence and predic-tors of severe obstetric morbidity: case-control study. BMJ. 2001;322(7294):1089-93. -WHO33 Organização Mundial de Saúde. Avaliação da Qualidade do Cuidado nas Complicações Graves da Gestação: A Abordagem do Near Miss da OMS para a Saúde Materna. Uruguay. OMS; 2011. -Reichenheim et al.,44 Reichenheim ME, Zylbersztajn F, Moraes CL, Lobato G. Severe acute obstetric morbidity (near miss): a review of the relative use of its diagnostic indicators. Arch Gynecol Obstet. 2009; 280 (3): 337-43. 2009 criteria |
Total of cases (considering any criteria): 157 - MNMR were: 33.2/1,000 live births by WHO; 155.2/1,000 live births by Waterstone 188.4/1,000 live births by Reichenheim criteria 2009 - 2.3% of the cases presented WHO criteria, 10.8% Waterstone criteria and 13.2% Reichenheim criteria 2009 - From 27 cases of WHO, 77.8% were positive in other classification, 14.8% were exclusive of WHO (thrombocytopenia) - From 25 cases classified as exclusively by Reichenheim 2009, 80% presented severe hypertension, 68% were admitted to ICU, 20% received blood transfusion, 4% had pulmonary edema and 4% developed hemorrhage - The cases classified by Reichenheim 2009 and by Waterstone (105), 94.3% were pre-eclampsia, eclampsia and HELLP syndrome |
Oliveira & Costa,2020 Oliveira LC, Costa AAR. Óbitos Fetais e Neonatais entre Casos de Near Miss Materno. Rev Assoc Med Bras. 2013; 59 (5): 487-94. 2013 |
Recife, Pernambuco |
2007-2010 |
-Cross-sectional descriptive -Review on medical files |
-Maternities and obstetric ICU admissions at a tertiary public unit - 19,940 live births and 2,997 ICU admissions |
-WHO33 Organização Mundial de Saúde. Avaliação da Qualidade do Cuidado nas Complicações Graves da Gestação: A Abordagem do Near Miss da OMS para a Saúde Materna. Uruguay. OMS; 2011.
|
Near miss cases= 255 - MNMR= 12.8/1,000 live births - Hypertensions disorders occurred in 62.7%, mainly severe pre-eclampsia (49%) and eclampsia (13.7%) - The most frequent infection was endometritis (25.1%), followed by pneumonia (19.6%) - 35.3% of postpartum hemorrhage was also identified - Laboratory criteria was present in 59.6% of the participants, while clinical and management criteria occurred in 50.2% and 49%, respectively. |
Amorim et al.,2121 Amorim MM, Katz L, Barros AS, Almeida TS, Souza AS, Faúndes A. Maternal outcomes according to mode of delivery in women with severe preeclampsia: a cohort study. J Matern Fetal Neonatal Med. 2014; 28 (6): 654-60. 2014 |
Recife, Pernambuco |
2008-2009 |
-Cohort -Bivariate analysis: RR complication according to the type of childbirth -Multivariate analysis: OR of complication according to the type of childbirth |
- 500 severe preeclampsia patients, without other clinical conditions, admitted at a tertiary hospitals |
-PLTC |
- Global PLTC according to the type of childbirth: cesarean section -54% and vaginal - 32.7% - Conditions associated to cesarean section in women with severe preeclampsia: RR (95%CI) - Post-childbirth hemorrhage: RR=9.8 (2.4-39.9) -Hypertensive crisis: 1.58 (1.22-2.06) - Associated factors with PLTC in 500 women: Cesarean section - OR=1,91 (1.52-4.57) Pre-childbirth HELLP syndrome- OR=3.91 (1.55-9.88) |
Galvao et al.,2222 Galvão LP, Alvim-Pereira F, de Mendonça CM, Menezes FE, Góis KA, Ribeiro RF, Gurgel RQ. The prevalence of severe maternal morbidity and near miss and associated factors in Sergipe, Northeast Brazil. BMC Pregnancy Childbirth. 2014; 14: 25. doi:10.1186/1471-2393-14-25 https://doi.org/10.1186/1471-2393-14-25...
2014 |
Sergipe |
2011-2012 |
-Case-control incidence -Medical files, prenatal care cards and interviews |
-Two referral maternities for the whole State -16,243 live births |
-WHO33 Organização Mundial de Saúde. Avaliação da Qualidade do Cuidado nas Complicações Graves da Gestação: A Abordagem do Near Miss da OMS para a Saúde Materna. Uruguay. OMS; 2011.
|
-Total of SMM (or PLTC): 1,102 cases -Near miss cases: 77/Maternal deaths: 17 - MNMR: 4.7/1,000 live births; SMMR: 67.8/1,000 live births - Mortality rate: 18%; MNM/MD ratio=4.5 - Most frequent morbidities: 67.5% hypertensive disorders, 15.4% hemorrhagic disorders and 61.7% one of the critical interventions defined by WHO; - Most frequent criteria: 87.1% £1 management criteria, 41.4% ≥1 clinical criteria and 21.4% ≥1 laboratorial criteria - Statistically significant association to near-mis: previous abortion (OR=2.68), previous cesarean section (OR=1.64) and current (2.36) and conscience alteration (OR=15.18) |
Menezes et al.,2323 Menezes FE, Galvão LP, de Mendonça CM, Góis KA, Ribeiro RF Jr, Santos VS, Gurgel RQ. Similarities and differences between WHO criteria and two other approaches for maternal near miss diagnosis. Trop Med Int Health. 2015; 20 (11): 1501-06. 2015 |
Sergipe |
2011-2012 |
-Cross-sectional descriptive -Hospital files |
- 20,435 women admitted in two maternities , 1 ,196 with potential life threatening conditions (PLTC) |
-Waterstone et al.3131 Waterstone M, Bewley S, Wolfe C. Incidence and predic-tors of severe obstetric morbidity: case-control study. BMJ. 2001;322(7294):1089-93.
-WHO33 Organização Mundial de Saúde. Avaliação da Qualidade do Cuidado nas Complicações Graves da Gestação: A Abordagem do Near Miss da OMS para a Saúde Materna. Uruguay. OMS; 2011. -Reichenheim et al.44 Reichenheim ME, Zylbersztajn F, Moraes CL, Lobato G. Severe acute obstetric morbidity (near miss): a review of the relative use of its diagnostic indicators. Arch Gynecol Obstet. 2009; 280 (3): 337-43. 2009 criteria |
- MNMR= Reichenheim et al.4 2009= 59/1,000 LB Waterstone et al.31= 24.8/1,000 LB WHO33 Organização Mundial de Saúde. Avaliação da Qualidade do Cuidado nas Complicações Graves da Gestação: A Abordagem do Near Miss da OMS para a Saúde Materna. Uruguay. OMS; 2011.= 4.7/1,000 LB - 6.4% of the cases were compatible with WHO criteria, 33,8% compatible with Waterstone and 80,2% compatible with Reichenheim 2009 - Of the 77 WHO cases, 4 were exclusive, 72 were positive also by Reichenheim 2009 and 37 also positive by Waterstone; - The most frequent criteria according to Reichenheim 2009 were: 54.8% severe hypertension, 28.3% blood transfusion and 7.5% ICU admission - The most frequent criteria according to Waterstone were: 71.6% severe pre-eclampsia, 13% eclampsia and 7.6% HELLP syndrome |
Pacheco et al.,2424 Pacheco AJ, Katz L, Souza AS, de Amorim MM. Factors associated with severe maternal morbidity and near miss in the São Francisco Valley, Brazil: a retrospective, cohort study. BMC Pregnancy Childbirth. 2014; 14: 91. 2014 |
Vale de Sao Francisco, Pernambuco |
2011 |
-Retrospective cohort -Prenatal care cards, medical files -Multivariate analysis -Logistic regression |
- 2,291 women |
-WHO33 Organização Mundial de Saúde. Avaliação da Qualidade do Cuidado nas Complicações Graves da Gestação: A Abordagem do Near Miss da OMS para a Saúde Materna. Uruguay. OMS; 2011.
|
- 400 (17.5%) of severe maternal morbidity cases and 24 (1.1%) cases with one or more criteria of maternal near miss were identified - Association to severe maternal morbidity and/or maternal near miss= previous history on cesarean section (RR:1.43), presence of chronic hypertension (RR:6.78), current cesarean section (OR:2.6), presence of comorbidity (OR:3.4) and less than 6 pre-natal consultation (OR:1.13) |
Souza et al.,2525 Souza MAC, Souza TH, Gonçalves AK. Fatores determinantes do near miss materno em uma unidade de terapia intensiva obstétrica. Rev Bras Ginecol Obstet. 2015; 37 (11): 498-504. 2015 |
Natal, Rio Grande do Norte |
2013-2014 |
-Cross-sectional -Review on medical files - χ2 tes ts |
- 492 |
-Waterstone et al.3131 Waterstone M, Bewley S, Wolfe C. Incidence and predic-tors of severe obstetric morbidity: case-control study. BMJ. 2001;322(7294):1089-93.
-Geller et al.3333 Geller SE, Rosenberg D, Cox SM, Kilpatrick S. Defining a conceptual framework for near miss maternal morbidity. J Am Med Womens Assoc. 2002; 57 (3): 135-9.
|
- There were more near miss cases when woman presented= 1) hypertensive disorders (50.0%); 2) severe sepsis (23.8%); 3) severe hemorrhage (21.4%) - Clinical conditions with significant relative risk for MNM: first childbirth (OR=3.1), hypertensive gestational disorders (OR=8.0) and cesarean section (OR=39.2) |
Oliveira & Costa,2626 Oliveira LC, Costa AAR. Near miss materno em unidade de terapia intensiva: aspectos clínicos e epidemiológicos. Rev Bras Ter Intensiva. 2015; 27 (3): 220-7 2015 |
Recife, Pernambuco |
2007-2010 |
-Cross-sectional descriptive -Review on medical files |
- 2,997 |
-WHO33 Organização Mundial de Saúde. Avaliação da Qualidade do Cuidado nas Complicações Graves da Gestação: A Abordagem do Near Miss da OMS para a Saúde Materna. Uruguay. OMS; 2011.
|
- MNMR: 12.8/1,000 LB -The main disorders presented were: hypertensive, hemorrhagic and infectious -Among the hypertensive disorders cases: 42.3% severe pre-eclampsia, 13.7% eclampsia and 6.7% gestational aggravated chronic hypertension; HELLP syndrome in 41.2% of the participants - 59.6% presented one or more laboratorial criteria, 50.2% presented one or more clinical criteria and 49% presented one or more of management criteria - Clinical and laboratorial criteria appeared mostly during pregnancy (42.2 clinical and 57.9% laboratorial), while the management criteria occurred mainly in postpartum (45.6%) |
Madeiro et al.2727 Madeiro AP, Cronemberger AR, Lacerda EZG, Brasil LG. Incidence and determinants of severe maternal morbidity: a transversal study in a referral hospital in Teresina, Piauí, Brazil. BMC Pregnancy and Childbirth. 2015, 15: 210. 2015 |
Teresina, Piauí |
2012-2013 |
-Cross-sectional descriptive -Review on medical files -Multivariate analysis |
- 5,841 |
-WHO33 Organização Mundial de Saúde. Avaliação da Qualidade do Cuidado nas Complicações Graves da Gestação: A Abordagem do Near Miss da OMS para a Saúde Materna. Uruguay. OMS; 2011.
|
- MNMR: 9.6/1,000 LB; - SMMR: 11.3/1,000 LB - MNM/MD ratio: 5.6:1; - Mortality rate: 15.2% - Main determinants of severe maternal morbidity (near miss) and maternal death: hypertension (86.1%), hemorrhage (10%) and infectious diseases (2.9%). Severe pre-eclampsia, eclampsia and HELLP syndrome were the main causes of maternal near miss -Association with MNM: caesarean section (OR=6.2) and " 5 days hospitalization (OR=6.7) |
Barbosa et al.,2828 Barbosa IRC, Silva WBM, Cerqueira GSG, Novo NF, Almeida FA, Novo JLVG. Maternal and fetal outcome in women with hypertensive disorders of pregnancy: the impact of prenatal care. Ther Adv Cardiovasc Dis. 2015; 9 (4): 140-6. 2015 |
Sorocaba, Sao Paulo |
4 anos (nao informado) |
-Retrospective cohort |
- 1,501 women in a referral hospital: Chronic arterial hypertension (564), pre-eclampsia (579), eclampsia (74) and pre-eclampsia / eclampsia overlapping chronic arte-rial |
-WHO33 Organização Mundial de Saúde. Avaliação da Qualidade do Cuidado nas Complicações Graves da Gestação: A Abordagem do Near Miss da OMS para a Saúde Materna. Uruguay. OMS; 2011.
|
- MNM R of all hypertensive = 5,4/1,000 LB - MNM highest ratio for isolated or overlapping eclampsia, - MNM lowest ratio for chronic hypertension and pre-eclampsia. Prenatal and maternal near miss association: (p< 0,01): - " 6 consultations: MNMR=3.05/1,000 LB - < 6 consultations: MNMR =8.27/1,000 LB - Without prenatal care: MNMR=9.48/1,000 LB |
Ferreira etal.,2929 Ferreira EC, Pacagnella RC, Costa ML, Cecatti JG. The Robson ten-group classification system for appraising deliveries at a tertiary referral hospital in Brazil. Int J Gynaecol Obstet. 2015a; 129 (3): 236-9. 2015 |
Campinas, Sao Paulo |
2009-2013 |
-Cross-sectional descriptive -Review on medical files |
- 12,771 women admitted at a referral University hospital |
-ICU admission |
-Near miss incidence: 50.5/1,000 childbirths -Vaginal section: 16/1,000 childbirths -Cesarean section: 91/1,000 childbirths -OR cesarean and near miss association: 6.24 (95% CI 5.06-7.69) |
Vidal et al.,3030 Vidal, CE, Carvalho MAB, Grimaldi IR, Reis MC; Baêta MCN, Garcia RB, Silva SAR. Morbidade materna grave na microrregião de Barbacena/MG. Cad Saúde Coletiva. 2016; 24 (2): 131-8. 2016 |
Barbacena, Minas Gerais |
2014 (Feb-Aug) |
-Case-control -Interview and medical files |
- 92 cases and 1 84 controls -Santa Casa Maternity (SUS) |
-Life threatening conditions |
-MNM indicators not described. -Associated factors: previous hypertension - OR=14.3 (CI=4.5-45.5); cesarean section- OR=3.2 (1.6-6.3) |