2014, Number 10
<< Back Next >>
Ginecol Obstet Mex 2014; 82 (10)
Causes of delays in obstetric complications care. What is necessary to address?
Rodríguez-Angulo E, Palma-Solís M, Zapata-Vázquez R
Language: Spanish
References: 57
Page: 647-658
PDF size: 373.44 Kb.
ABSTRACT
This article reviews the published evidences associated with the causes
of delays in cases of maternal death and in those for which the patients
survived the obstetric complication, in order to build an analytical
framework to identify factors not investigated yet, as part of the search
for a preventive model of maternal risk. We reviewed articles in the
PubMed, EBSCO and Web of Science database using the following
keywords: delays, maternal, mortality. Latin American items were ex tracted from the Google Scholar database. Three types of delays were
analyzed: in seeking care (first delay) in reaching care (second delay),
and in diagnosis and treatment (third delay). The main causes of the
first delay were lack of decision to seek care at the time of complication
(79%) and not recognizing the warm signs of the complication (82.1%).
The second delay was mainly due to the lack of transport (92.3%) at
the time of transfer to another hospital. The third delay was related to
poor quality of care in health services (63%). Educational interventions
appropriate to the context are required to integrate knowledge of
warning signs and conditions of gender. Studies are needed to analyze
the causes of delay in health services in order to be able to propose
preventive models aimed at their reduction.
REFERENCES
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet 2010;375:1609-23.
WHO. MDG5: improve maternal health.http://www.who. int/topics/millennium_development_goals/maternal_ health/en/index.html (consultado el 8 de junio de 2013)
Filippi V, Richard F, Lange I, Ouattara F. Identifying barriers from home to the appropriate hospital through near-miss audits in developing countries. Best Pract Res Clin Obstet Gynaecol 2009;23:389-400.
Hynes M, Sakani O, Spiegel P, Cornier N. A study of refugee maternal mortality in 10 countries, 2008-2010. Int Perspect Sex Reprod Health 2012;38:205-13.
Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med 1994; 38:1091-110.
OMS. Clasificación Internacional de Enfermedades y Problemas Relacionados con la Salud. 10a revisión. Geneva: World Health Organization. Ginebra: WHO, 1992.
WHO, UNICEF, UNFPA, The World Bank. Maternal mortality in 2005: Estimates developed by WHO, UNICEF, UNFPA and the World Bank. 2007. Available online at: http://www.who.int/makinq_pregnancy_ safer/documents/ 9789241596213/en/index.html (Fecha de acceso 8 de Junio de 2013).
Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet 2006;367:1066-74.
Paxton A, Maine D, Freedman I, Fray D, Lobis, S. The evidence from emergency obstetric care. Int J Gynaecol and Obstet 2005;88:181-193.
Combs TV, Sundby J, Malata A. Piecing Together the maternal Death Puzzle through Narratives: The three delays Model Revisited. PLoS ONE 7(12): e52090. doi:10.1371/ journal.pone.0052090
Lotufo FA, Parpinelli MA, Haddad SM, Surita FG, Cecatti JG. Appiying the new concept of maternal near-miss in an intensive care unit. Clinics (Sao Paulo) 2012;67:225-30.
Igwegbe AO, Eleje GU, Ugboaja JO, Ofiaeli RO. Improving maternal mortality at a university teaching hospital in Nnewi, Nigeria. Int J Gynaecol Obstet 2012;116:197-200.
Paul B, Mohapatra B, Kar K. Maternal Deaths in a Tertiary Health Care Centre of Odisha: An In-depth Study Supplemented by Verbal Autopsy. Indian J Community Med 2011;36:213-6.
Núñez RM, Duarte MB, Javier L, Arroyo L. Más allá de las cifras: detección de eslabones críticos en los procesos de atención para prevenir muertes maternas. Género y Salud en Cifras 2005;3:5-15.
Nashef SA. What is a near miss? Lancet 2003;361:180-1.
Harden A, Brunton G, Fletcher A, Oakley A, Burchett H, Backhans M. Young people, pregnancy and social exclusión: A systematic synthesis of research evidence to identify effective, appropriate and promising approaches for prevention and support. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London; 2006;124.
Walker GJ, Ashley DE, McCaw AM, Bernard GW. Maternal mortality in Jamaica. Lancet 1986;1:486-8.
Rosenstein 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.
Shan N, Hossain N, Shoaib R, Hussain A, Gillani R, Khan NH. Socio-demographic characteristics and the three delays of maternal mortality. J Coll Physicians Surg Pak 2009; 19:95-8.
Okour AM, Khader Y, Amarin Z, Jaddou H, Gharaibeh M. Maternal mortality in Jordán: role of substandard care and delays. East Mediterr Health J 2012;18:426-31.
Hirose A, Borchert M, Niksear H, Alkozai AS, Cox J, Gardiner J, et al. Difficulties leaving home: a cross-sectional study of delays in seeking emergency obstetric care in Herat, Afghanistan. Soc Sci Med 2011;73:1003-13.
Mazza M, Vallejo C, González BM. Mortalidad materna: análisis de las tres demoras. Rev Obstet Ginecol Venez 2012;72:233-48.
Amaya A, Bolaños A, Cuevas A, Díaz D. Factores asociados con la mortalidad materna en las afiliadas a una EPS del régimen subsidiado, durante el año 2008. Cuadernos latinoamericanos de administración 2010;7:103-18.
Wachuku-king S, Stanley S. The state of motherhood in Sierra Leone. Afr Health 1994;16: 10-1.
Lori JR, Starke AE. A critical analysis of maternal morbidity and mortality in Liberia, West África. Midwifery 2012;28:67-72.
Ghazi Tabatabaie M, Moudi Z, Vedadhir A. Home birth and barriers to referring women with obstetric complications to hospitals: a mixed-methods study in Zahedan, southeastern Irán. Reprod Health 2012; 9:5.
Mullick SS, Serle E. Achieving Millennium Development Goals 4 and 5: a snapshot of life in rural India. Bjog 2011;118(suppl 2):104-7.
Umeora OU, Egwuatu VE. The role of unorthodox and traditional birth care in maternal mortality. Trop Doct 2010;40:13-7.
Santos RL, Luna VF, González RM. Mortalidad materna: factores determinantes modificables mediante políticas públicas en la región La Libertad. UCV Scientia 2010;2:22-33.
Binder P, Johnsdotter S, Essen B. Conceptualizing the prevention of adverse obstetric outcomes among immigrants using the ‘three delays’ framework in a high-income context. Soc Sci Med 2012;75:2028-36.
Killewo J, Anwar I, Bashir I, Yunus M, Chakraborty J. Perceived delay in healthcare-seeking for episodes of serious illness and its implications for safe motherhood interventions in rural Bangladesh. J Health Popul Nutr 2006;24:403-12.
Nahar S, Banu M, Nasreen HE. Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a crosssectional study. BMC Pregnancy Childbirth 2011; 11:11.
Rodríguez Villamizar LA, Ruiz-Rodriguez M, Jaime Garda ML. [Benefits of combining methods to analyze the causes of maternal mortality, Bucaramanga, Colombia]. Rev Panam Salud Publica 2011;29:213-9.
Kabali E, Gourbin C, De Brouwere V. Complications of childbirth and maternal deaths in Kinshasa hospitals: testimonies from women and their families. BMC Pregnancy Childbirth 2011;11:29.
Teela KC, Mullany LC, Lee Cl, Poh E, Paw P, Masenior N, et al. Community-based delivery of maternal care in conflictaffected areas of eastern Burma: perspectives from lay maternal health workers. Soc Sci Med 2009;68:1332-40.
D’Ambruoso L, Byass P, Qomariyah SN, Ouedraogo M. A lost cause? Extending verbal autopsy to investigate biomedical and socio-cultural causes of maternal death in Burkina Faso and Indonesia. Soc Sci Med 2010;71:1728-38.
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;105:252-6.
Bonnet MP, Deneux-Tharaux C, Bouvier-Colle MH. Critical care and transfusion management in maternal deaths from postpartum haemorrhage. Eur J Obstet Gynecol Reprod Biol 2011;158:183-8.
Alvesson HM, Lindelow M, Khanthaphat B, Laflamme L. Shaping healthcare-seeking processes during fatal illness in resource-poor settings. A study in Lao PDR. BMC Health Serv Res 2012;12:477.
Mayca J, Palacios FE, Medina A, Velázquez J, Castañeda D. Percepciones del personal de salud y la comunidad sobre la adecuación cultural de los servicios materno perinatales en zonas rurales andinas y amazónicas de la región Huánuco. Rev Perú Med Exp Salud Publica 2009;26:145-60.
Rodríguez E, Aguilar P, Montero L, Hoil J, Andueza G. Demoras en la atención de complicaciones maternas asociadas a fallecimientos en municipios del sur de Yucatán, México. Rev Biomed 2012;23:23-32.
Sarker M, Schmid G, Larsson E, Kirenga S, De Allegri M, Neuhann F, et al. Quality of antenatal care in rural southern Tanzania: a reality check. BMC Res Notes 2010;3:209.
WHO (2007) Everybody’s business: strengthening health systems in low and middle income countries. Geneva: World Health Organization.
Knight HE, Self A, Kennedy SH. Why are women dying when they reach hospital on time? A systematic review of the ‘third delay’. PLoS One 2013;8:e63846.
Adisasmita A, Deviany PE, Nandiaty F, Stanton C, Ronsmans C. Obstetric near miss and deaths in public and prívate hospitals in Indonesia. BMC Pregnancy Childbirth 2008;8:10
Roost M, Altamirano VC, Liljestrand J, Essen B. Priorities in emergency obstetric care in Bolivia-maternal mortality and near-miss morbidity in metropolitan La Paz. BJOG 2009; 116:1210-7.
Filippi V, Brugha R, Browne E, Gohou V, Bacci A, De Brouwere V, et al. Obstetric audit in resource-poor setting: lessons from a multi-country Project auditing “near miss” obstetrical emergencies. Health Policy Plan 2004; 19:57-66.
Ronsmans C, Filippi V. Reviewing severe maternal morbidity: learning from survivors from life-threatening complications. World Health Organization. Beyond the numbers: Reviewing deaths and complications to make pregnancy safer. Geneva: WHO, 2004;103-124.
Pattison RC, Buchmann E, Mantel G, Schoon M, Rees H. Can enquiries into severe acute maternal morbidity act as a surrogate for maternal death enquiñes? BJOG 2003;110:889-93.
Wagaarachchi PT, Graham WJ, Penney GC, McCaw-Binns A, Yeboah Antwi K, Hall MH. Int J Gynaecol Obstet 2001; 742: 119-30
Pattison R. Assessing avoidable factors, missed opportunities and substandard care in confidential enquines into maternal deaths. Specialist Medicine 1998: 33-37.
D’Ambruoso L, Hussein J, Endang A. Improving Emergency Obstetric Care in Indonesian Communities with a confidential enquiry. Forum 10, Cairo, Egypt, 29 October-2 November 2006.
lyer A, Sen G, Sreevathsa A. Deciphering Rashomon: an approach to verbal autopsies of maternal deaths. Glob Public Health 2013;8:389-404.
Castro R, Campero L, Hernández B, Langer A. A study of maternal mortality in México through a qualitative approach. J Women Health Gend Based Med 2000;9:679-90.
Barnes-Josiah D, Myntti C, Augustin A The “Theree Deleys” as a framework for examining maternal mortality in Haiti. Soc Sci Medd 1998;46:981-993.
Commission on Social Determinants of Health (CSDH). Closing the gap in a generation: Health equity through action on the social determinants of health. Geneva: World Health Organization, 2008.
Rossi C. The etiology of maternal mortality in developed countries: a systematic review of literature. Arch Gynecol Obstet 2012;285:1499-503.