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Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2011, Number 2

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Rev Esp Med Quir 2011; 16 (2)

Epidemiological characteristics of direct maternal-obstetric mortality in entitled population of ISSSTE, Mexico

Yáñez VLB, Bernal ADA, Alcázar ÁLS, Ramírez CDP, Tena TC

Language: Spanish
References: 48
Page: 89-96
PDF size: 295.70 Kb.


ABSTRACT

Background: Maternal mortality is one of the most sensitive indicators of health conditions of the female population in reproductive age. This indicator is the fifth of the Millennium Development Goals.
Objective: To know the epidemiological pattern of maternal mortality due to direct obstetric causes at ISSSTE.
Material and methods: Cross-sectional study was performed to identify correlates in maternal mortality occurred during the period 2008 to 2010. The information was obtained from clinical records and death certificates.
Results: 80% of all maternal deaths from 2008 to 2010 were due to direct obstetric causes. Most deaths occurred in the puerperium. The main cause of direct obstetric death was hemorrhage. The etiology of this was uterine atony and abnormal placental adherence. In the majority of deaths deficiencies in quality of care (97.6%) were identified. Mothers with at least one previous cesarean had higher mortality due to hemorrhage. During night wards, the likelihood of having deaths due to obstetric hemorrhage was four more times. Those who had preeclampsia/eclampsia, with abdominal delivery were four times more likely to die.
Conclusions: Most maternal deaths by direct obstetric causes could have been avoided with better quality of care in pregnancy and prompt care and excellent quality in childbirth and postpartum.


REFERENCES

  1. Organización Mundial de la Salud. Resolución WHA 30, 43. Asamblea Mundial de la Salud, Ginebra, 1977

  2. Declaración Mundial sobre la Supervivencia, la Protección y el Desarrollo del Niño. Cumbre Mundial de la Infancia, 1990. E línea: http://educacionespecial.sepdf.gob.mx/educacioninclusiva/documentos/PoliticaInternacional/DeclaracionSPD.pdf

  3. Objetivos de desarrollo del Milenio en la Asamblea y Cumbre del Milenio. Naciones Unidas, 2000. En línea: http://www.cinu.org.mx/ninos/html/odm.htm#1

  4. Objetivo de desarrollo del milenio 5: Mejorar la salud materna. En línea: http://www.who.int/making_pregnancy_safer/topics/mdg/es/index.html

  5. Objetivos de desarrollo del milenio. INFORME 2010. En línea: http: //www.un.org/es/comun/docs/?path=/spanish/millenniumgoals/pdf/MDG_Report_2010_SP.pdf

  6. Mortalidad materna. Organización Mundial de la Salud: En línea: http: //www.who.int/making_pregnancy_safer/topics/maternal_mortality/es/index.html

  7. Trends in maternal mortality: 1990 to 2008. World Health Organization, World Bank, UNICEF, United Nations Population Fund. World Health Organization 2010. En línea: http://whqlibdoc.who.int/publications/2010/9789241500265_eng.pdf

  8. Hogan MC, Foreman KJ, Naghavi M, Ahn SY, et al. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet 2010;375:1609-1623.

  9. Hernández AM. Mortalidad materna en México, cifras 2009. Subsecretaría de Prevención y Promoción de la Salud. SSA. En línea: http: //maternidadsinriesgos.org.mx/documentos/parteria/1erforo/18junio/Muerte%20Materna%20Reunion%20Parteria.ppt.

  10. Tzul AM, Kestler E, Hernández-Prado B, Hernández-Girón C. Mortalidad materna en Guatemala: diferencias entre muerte hospitalaria y no hospitalaria. Salud Publica Mex 2006;48:183-192.

  11. Granja AC, Machungo F, Gomes A, Bergström S. Adolescent maternal mortality in Mozambique. J Adolesc Health 2001;28:303-306.

  12. Wall LL. Dead mothers and injured wives: the social context of maternal morbidity and mortality among the Hausa of northern Nigeria. Stud Fam Plann 1998;29(4): 341-359.

  13. Sistema Nacional de Información en Salud. Muertes Maternas. Secretaría de Salud. En línea: http://www.sinais.salud.gob.mx/ muertesmaternas/index.html

  14. SSA. Búsqueda intencionada de muertes en México. Informe 2008. Dirección General de Información en Salud. Secretaría de Salud. México, 2010. En línea: http://sinais.salud.gob.mx/cemece/

  15. Búsqueda intencionada de muertes maternas y de menores de cinco años y registro de nacimientos en los 101 municipios con bajo índice de desarrollo humano. Dirección General de Información en Salud. Secretaría de Salud. México, 2009. En línea: http://sinais.salud.gob.mx/cemece/

  16. Mortalidad Materna y Perinatal. Acciones para su reducción. Comité Nacional para el Estudio de la Mortalidad Materna y Perinatal. DGA/SSA. 1994

  17. Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet 2006;367:1066-1074.

  18. INEGI/Secretaría de Salud. Dirección General de Información en Salud. Base de datos de Defunciones, 2008.

  19. Prual A, Bouvier-Colle MH, de Bernis L, Breart G. Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates. Bull World Health Organ 2000;78(5):593-602.

  20. Velasco-Murillo V, Navarrete-Hernández E, Hernández-Alemán F, Anaya-Coeto S y col. Mortalidad materna en el IMSS. Resultados iniciales de una intervención para su reducción. Cir Ciruj 2004;72(4):293-300.

  21. Velasco-Murillo V, Navarrete-Hernández E. Mortalidad materna en el IMSS. Mortalidad materna en el IMSS, 1991-2005. Un periodo de cambios. Rev Med Inst Mex Seguro Soc 2006;44(Supl 1):S121-S128.

  22. Velasco-Murillo V, Navarrete-Hernández E, de la Cruz-Mejía L. El descenso de la mortalidad materna en el IMSS, 2000-2005. ¿Azar o resultado de acciones específicas? Rev Med Inst Mex Seguro Soc 2008;46(2):211-218.

  23. Veloz-Martínez MG, Martínez-Rodríguez OA, Ahumada-Ramírez E, Puello-Tamara ER y col. Eclampsia, hemorragia obstétrica y cardiopatía como causa de mortalidad materna en 15 años de análisis. Ginecol Obstet Mex 2010;78(4):215-218.

  24. McMahon MJ, Li R, Schenck AP, Oishan AF, Royce RA. Previous cesarean birth. A risk for placenta previa? J Reprod Med 1997;42:409-412.

  25. Taylor VM, Kramer MD, Vaughan TL, Peacock S. Placenta previa and prior cesarean delivery: how strong is the association? Obstet Gynecol 1994;84:55-57.

  26. To WW, Leung WC. Placenta previa and previous cesarean section. lnt J Gynaecol Obstet 1995;51:25-31.

  27. Hendricks MS, Chow YH, Bhagavath B, Singh K. Previous cesarean section and abortion as risk factors for developing placenta previa. J Obstet Gynaecol Res 1999;25(2):137-142.

  28. Rasmussen S, Albrechtsen S, Dalaker K. Obstetric history and the risk of placenta previa. Acta Obstet Gynecol Scand 2000;79(6):502-507.

  29. Chattopadhyay SK, Karif H, Sherbeeni MM. Placenta previa and accreta after previous caesarean section. Eur J Obstet Gynecol Reprod Biol 1993;52:151-156.

  30. Zaideh SM, Abu-Heija AT, El-Jaliad MF. Placenta previa and accreta: analysis of a two-year experience. Gynecol Obstet lnvest 1998;46:96-98.

  31. Gardeil F, Daly S, Tumer MJ. Histerectomía periparto: Reporte de 11 casos. Rev Fr Gyneol Obstet 1995;90:431-434.

  32. Stanco LM, Schimmer DB, Paul RH, Mishell DR Jr. Emergency peripartum hysterectomy and associated risk factors. Am J Obstet Gynecol 1993;163: 879-883.

  33. Nieisen TF, Hagberg H, Ljungbiad U. Placenta previa and antepartum hemorrhage after previous cesarean section. Gynecol Obstet lnvest 1989;27:88-90.

  34. Cameron CA, Roberts CL, Olive EC, Ford JB, Fischer WE. Trends in postpartum haemorrhage. Aust NZ J Public Health 2006;30(2):151-156.

  35. Joseph KS, Rouleau J, Kramer MS, Young DC, et al. Investigation of an increase in postpartum haemorrhage in Canada. BJOG 2007;114(6):751-759.

  36. Ford JB, Roberts CL, Simpson JM, Vaughan J, Cameron CA. Increased postpartum hemorrhage rates in Australia. Int J Gynaecol Obstet 2007;98(3):237-243.

  37. Knight M, Callaghan WM, Berg C, Alexander S, et al. Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group. BMC Pregnancy Childbirth 2009;9:55.

  38. Al-Zirqi I, Vangen S, Forsén L, Stray-Pedersen B. Effects of onset of labor and mode of delivery on severe postpartum hemorrhage. Am J Obstet Gynecol 2009;201(3):273.e1-9.

  39. Waterstone M, Bewley S, Wolfe C. Incidence and predictors of severe obstetric morbidity: case-control study. BMJ 2001;322(7294):1089-1093.

  40. Thia EW, Tan LK, Devendra K, Yong TT, et al. Lessons learnt from two women with morbidly adherent placentas and a review of literature. Ann Acad Med Singapore 2007;36(4):298-303.

  41. Clark SL, Belfort MA, Dildy GA, Herbst MA, et al. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obstet Gynecol 2008;199(1):36.e1-5.

  42. Duley L. The global impact of preeclampsia and eclampsia. Semin Perinatol 2009;33(3):130-137.

  43. Soares NVM, De Souza KV, Freygang TC, Correa V, Saito MR. Mortalidad maternal por pré-eclâmpsia/eclâmpsia em um estado do Sul do Brasil. Rev Bras Ginecol Obstet 2009;31(11):566-573.

  44. Souza JP, Cecatti JG, Faundes A, Morais SS, et al. World Health Organization 2005 Global Survey on Maternal and Perinatal Health Research Group. Maternal near miss and maternal death in the World Health Organization's 2005 global survey on maternal and perinatal health. Bull World Health Organ 2010;88(2):113-119.

  45. Zhang J, Meikle S, Trumble A. Severe maternal morbidity associated with hypertensive disorders in pregnancy in the United States. Hypertens Pregnancy 2003;22(2):203-212.

  46. Moodley J. Maternal deaths associated with hypertensive disorders of pregnancy: a population-based study. Hypertens Pregnancy 2004;23(3):247-256.

  47. Moodley J. Maternal deaths due to hypertensive disorders in pregnancy: Saving mothers report 2002-2004. Cardiovasc J Afr 2007;18(6):358-361.

  48. Zhang WH, Alexander S, Bouvier-Colle MH, Macfarlane A; MOMS-B Group. Incidence of severe pre-eclampsia, postpartum haemorrhage and sepsis as a surrogate marker for severe maternal morbidity in a European population-based study: the MOMS-B survey. BJOG 2005;112(1):89-96.




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