2012, Number 1
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Rev Biomed 2012; 23 (1)
Delays in the care of complications associated with maternal deaths in municipalities in southern Yucatán, México
Rodríguez-Angulo E, Aguilar-Pech P, Montero-Cervantes L, Hoil-Santos J, Andueza-Pech G
Language: Spanish
References: 141
Page: 23-32
PDF size: 325.68 Kb.
ABSTRACT
Introduction. Maternal deaths occur from complications in pregnancy, childbirth, and postpartum events. Eclampsia, hemorrhaging, and sepsis are the main complications resulting in death that arise from delays in attending to pregnant woman.
Objective. Describe the effects of major delays or delays in care of complications associated with maternal deaths in 6 municipalities in Southern Yucatán, México.
Materials and Methods. Death certificates and clinical files of maternal deaths from 2006 to 2008 were reviewed. Questionnaires were completed by close family members, covering sociodemographic characteristics, prenatal control and critical route. The “three delays model” was applied to analyze complications and delays in care, and percentages of delays were calculated.
Results. Delays in receiving quality care at a health facility (third delay) and not recognizing warning signs of complications (first delay) were the main delays. The third and first delays constituted 82.4% of the total.
Conclusions. Focused interventions are needed to reduce the three delays. We recommend training maternal mortality-committees personnel to apply the “three delays model”; and local leaders need to monitor pregnant woman more closely.
REFERENCES
Hogan MC, Foreman KJ, Naghavi M, Ahn SY,
Wang M, Makela SM, Lopez AD, Lozano R,
Murray CJ. Maternal mortality for 181 countries,
1980-2008: a systematic analysis of progress towards
Millennium Development Goal 5. Lancet 2010;
World Health Organization (WHO). The World
Health Report 2005: Make every mother and child
count. Geneva, Switzerland. WHO, 2005.
Instituto Nacional de Estadística y Geografía.
México. Mortalidad materna. Consulta de defunciones
maternas por causas detalladas CIE según año de
registro. Citado: 19 de septiembre de 2011. Disponible:
González-Rosales R, Ayala-Leal I, Cerda-López
JA, Cerón-Saldaña MA. Mortalidad maternal en el
Hospital General de Matamoros Dr. Alfredo Pumajero
Lafaurie durante un periodo de 10 años. Ginecol Obstet
Veloz-Martínez MG, Martínez-Rodríguez OA,
Ahumada-Ramírez E, Puello-Tamara ER,
Amezcua-Galindo FJ, Hernández-Valencia M.
Eclampsia, obstetric hemorrhage and heart disease as
a cause of maternal mortality in 15 years of analysis.
Ginecol Obstet Mex. 2010; 78(4):215-8.
Rodríguez-Angulo E, Montero-Carvantes
L, Andueza-Pech G, Manrique-Vergara W.
Características médico-sociales de las muertes
maternas en una comunidad maya de Yucatán, Méx.
Ginecol Obstet Mex. 2007; 75(2):79-85.
Elú MC, Santos-Pruneda E. Mortalidad materna:
una tragedia evitable. Perinatol Reprod Hum 2004;
Thaddeus S, Maine D. Too far to walk: maternal
mortality in context. Soc Sci Med 1994; 38(8):1091-
Barkat A, Rahman M, Bose ML, Com M, Akther
S. Modelling the fi rst two delays of the “three delays
model” for emergency obstetric care in Bangladesh:
a choice model approach. J Health Popul Dev Ctries
Cham M, Sundby J, Vangen S. Maternal mortality
in the rural Gambia, a qualitative study on access to
emergency obstetric care. Reproductive Health 2005;
2:3. Available from: http://www.reproductive-healthjournal.
Lori JR, Starke AE. A critical analysis of maternal
morbidity and mortality in Liberia, West Africa.
Midwifery 2012; 28(1):67-72.
Kloos H. Illnes and health behavior in Addis Ababa and
rural central Ethiopia. Soc Sci Med 1987; 25:1003-19.
Thonneau PF, Matsudai T, Alihonou E, De Souza J,
Faye O, Moreau JC, Djanhan Y, Wellfens-Ekra C,
Goyaux N. Distribution of causes of maternal mortality
during delivery and post-partum: results of an African
multicenter hospital-based study. Eur J Obstet Gynecol
Reprod Biol 2004; 114(2):150-4.
Rosestein MG, Romero M, Ramos S. Maternal
mortality in Argentina: a closer look at women who
die outside of the health system. Matern Child Health
Castro R, Campero L, Hernández B, Langer A.
A study of maternal mortality in Mexico through a
qualitative approach. J Women Health Gend Based
Rosado-Alcocer L, Rodríguez-Angulo E, Andueza-
Pech G. Evaluación del modelo de los tres retrasos
en las defunciones maternas en Mérida, Yucatán. En:
Investigación y Salud 3. Ed. Universidad Autónoma de
Yucatán. México 2008. Pp 325-339.
Álvarez-Gayou JL. Cómo hacer investigación
cualitativa. Fundamentos y metodología. En: Métodos
básicos. Ed. Paidós. México, 2005. pp 127-8.
Shehu D, Ikeh A, Kuna M. Mobilizing transport for
obstetric emergency in north-western Nigeria. Int J
Gynaecol Obstet 1997; 59:S173-80.
Waiswa P, Kallander K, Peterson S, Tomson G,
Pariyo GW. Using the three delays model to understand
why newborn babies die in Eastern Uganda. Trop Med
Int Health. 2010; 15(8):964-72.
Cervera-Montejano MD, Méndez-González RM.
Maternidad y género. Un panorama general desde
Yucatán. En: Género y Salud en el Sureste de México.
Vol.1 Ed. El Colegio de la Frontera Sur. México, 1997.
Méndez-González RM, Cervera-Montejano MD.
Comparación de la atención del parto normal en los
sistemas hospitalario y tradicional. Sal Pub Mex
Programa Nacional de Salud 2007-2012. Secretaría
de Salud, México, 2007. pp-18.
Briones JC, Díaz de León M, Meneses C. Estrategias
para reducir la mortalidad materna hospitalaria en el
Estado de México. Revista de la Asociación Mexicana
Hutchinson C, Lange I, Kanhonou L, Fillipi V,
Borchert M. Exploring the sustainability of obstetric
near-miss case reviews: a qualitative study in the South
of Benin. Midwifery 2010; 26(5):537-43.
Dumont A, Tourigny C, Fournier P. Improving
obstetric care in low-resource setting: implementation
of facility-based maternal death reviews in fi ve pilot
hospitals in Senegal. Hum Resour Health 2009; 7:61.
Rodríguez-Angulo E, Andueza-Pech G, Rosado-
Alcocer L, Ortíz-Panozo E, Hernández-Prado
B. Efecto de una intervención comunitaria para
mejorar conocimientos sobre signos de alarma de
complicaciones maternas en mujeres mayas de Yucatán,
México: ensayo controlado, aleatorizado. Rev Inv Clin.
Ortega-Canto JE. Género, generaciones y
transacciones. Ed. El Colegio de Michoacán. México,
2010. pp 13-523.rítica y Terapia Intensiva. 2009; 23(1):16-
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, Lopez AD, Lozano R, Murray CJ. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet 2010; 375(976):1609-23.
World Health Organization (WHO). The World Health Report 2005: Make every mother and child count. Geneva, Switzerland. WHO, 2005.
Instituto Nacional de Estadística y Geografía. México. Mortalidad materna. Consulta de defunciones maternas por causas detalladas CIE según año de registro. Citado: 19 de septiembre de 2011. Disponible: http://www.inegi.org.mx
González-Rosales R, Ayala-Leal I, Cerda-López JA, Cerón-Saldaña MA. Mortalidad maternal en el Hospital General de Matamoros Dr. Alfredo Pumajero Lafaurie durante un periodo de 10 años. Ginecol Obstet Mex. 2010; 78(4):219-25.
Veloz-Martínez MG, Martínez-Rodríguez OA, Ahumada-Ramírez E, Puello-Tamara ER, Amezcua-Galindo FJ, Hernández-Valencia M. Eclampsia, obstetric hemorrhage and heart disease as a cause of maternal mortality in 15 years of analysis. Ginecol Obstet Mex. 2010; 78(4):215-8.
Rodríguez-Angulo E, Montero-Carvantes L, Andueza-Pech G, Manrique-Vergara W. Características médico-sociales de las muertes maternas en una comunidad maya de Yucatán, Méx. Ginecol Obstet Mex. 2007; 75(2):79-85.
Elú MC, Santos-Pruneda E. Mortalidad materna: una tragedia evitable. Perinatol Reprod Hum 2004; 18(1):44-52.
Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med 1994; 38(8):1091- 110.
Barkat A, Rahman M, Bose ML, Com M, Akther S. Modelling the first two delays of the “three delays model” for emergency obstetric care in Bangladesh: a choice model approach. J Health Popul Dev Ctries 1997; 1(1):57-67.
Cham M, Sundby J, Vangen S. Maternal mortality in the rural Gambia, a qualitative study on access to emergency obstetric care. Reproductive Health 2005; 2:3. Available from: http://www.reproductive-healthjournal.com/content/2/1/3
Lori JR, Starke AE. A critical analysis of maternal morbidity and mortality in Liberia, West Africa. Midwifery 2012; 28(1):67-72.
Kloos H. Illnes and health behavior in Addis Ababa and rural central Ethiopia. Soc Sci Med 1987; 25:1003-19.
Thonneau PF, Matsudai T, Alihonou E, De Souza J, Faye O, Moreau JC, Djanhan Y, Wellfens-Ekra C, Goyaux N. Distribution of causes of maternal mortality during delivery and post-partum: results of an African multicenter hospital-based study. Eur J Obstet Gynecol Reprod Biol 2004; 114(2):150-4.
Rosestein MG, Romero M, Ramos S. Maternal mortality in Argentina: a closer look at women who die outside of the health system. Matern Child Health J 2008; 12:519-24.
Castro R, Campero L, Hernández B, Langer A. A study of maternal mortality in Mexico through a qualitative approach. J Women Health Gend Based Med. 2000; 9(6):679-90.
Rosado-Alcocer L, Rodríguez-Angulo E, Andueza-Pech G. Evaluación del modelo de los tres retrasos en las defunciones maternas en Mérida, Yucatán. En: Investigación y Salud 3. Ed. Universidad Autónoma de Yucatán. México 2008. Pp 325-339.
Álvarez-Gayou JL. Cómo hacer investigación cualitativa. Fundamentos y metodología. En: Métodos básicos. Ed. Paidós. México, 2005. pp 127-8.
Shehu D, Ikeh A, Kuna M. Mobilizing transport for obstetric emergency in north-western Nigeria. Int J Gynaecol Obstet 1997; 59:S173-80.
Waiswa P, Kallander K, Peterson S, Tomson G, Pariyo GW. Using the three delays model to understand why newborn babies die in Eastern Uganda. Trop Med Int Health. 2010; 15(8):964-72.
Cervera-Montejano MD, Méndez-González RM. Maternidad y género. Un panorama general desde Yucatán. En: Género y Salud en el Sureste de México. Vol.1 Ed. El Colegio de la Frontera Sur. México, 1997. pp 129-46.
Méndez-González RM, Cervera-Montejano MD. Comparación de la atención del parto normal en los sistemas hospitalario y tradicional. Sal Pub Mex 2002;44:129-36.
Programa Nacional de Salud 2007-2012. Secretaría de Salud, México, 2007. pp-18.
Briones JC, Díaz de León M, Meneses C. Estrategias para reducir la mortalidad materna hospitalaria en el Estado de México. Revista de la Asociación Mexicana de Medicina Crítica y Terapia Intensiva. 2009; 23(1):16-24.
Hutchinson C, Lange I, Kanhonou L, Fillipi V, Borchert M. Exploring the sustainability of obstetric near-miss case reviews: a qualitative study in the South of Benin. Midwifery 2010; 26(5):537-43.
Dumont A, Tourigny C, Fournier P. Improving obstetric care in low-resource setting: implementation of facility-based maternal death reviews in fi ve pilot hospitals in Senegal. Hum Resour Health 2009; 7:61.
Rodríguez-Angulo E, Andueza-Pech G, Rosado-Alcocer L, Ortíz-Panozo E, Hernández-Prado B. Efecto de una intervención comunitaria para mejorar conocimientos sobre signos de alarma de complicaciones maternas en mujeres mayas de Yucatán, México: ensayo controlado, aleatorizado. Rev Inv Clin. 2012 (En prensa).
Ortega-Canto JE. Género, generaciones y transacciones. Ed. El Colegio de Michoacán. México, 2010. pp 13-523.