Maternal near miss and maternal death in the World Health Organization's 2005 global survey on maternal and perinatal health
João Paulo Souza,José Guilherme Cecatti,Anibal Faundes,Sirlei Siani Morais,José Villar,Guillermo Carroli,Metin Gülmezoglu,Daniel Wojdyla,Nelly Zavaleta,Allan Donner,Alejandro Velazco,Vicente Bataglia,Eliette Valladares,Marius Kublickas,Arnaldo Acosta +14 more
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TLDR
In this paper, the authors developed an indicator of maternal near miss as a proxy for maternal death and to study its association with maternalfactors and perinatal outcomes.Abstract:
OBJECTIVE: To develop an indicator of maternal near miss as a proxy for maternal death and to study its association with maternalfactors and perinatal outcomes. METHODS: In a multicenter cross-sectional study, we collected maternal and perinatal data from the hospital records of a sample of women admitted for delivery over a period of two to three months in 120 hospitals located in eight Latin American countries. We followed a stratified multistage cluster random design. We assessed the intra-hospital occurrence of severe maternal morbidity and the latter's association with maternal characteristics and perinatal outcomes. FINDINGS: Of the 97 095 women studied, 2964 (34 per 1000) were at higher risk of dying in association with one or more of the following: being admitted to the intensive care unit (ICU), undergoing a hysterectomy, receiving a blood transfusion, suffering a cardiac or renal complication, or having eclampsia. Being older than 35 years, not having a partner, being a primipara or para > 3, and having had a Caesarean section in the previous pregnancy were factors independently associated with the occurrence of severe maternal morbidity. They were also positively associated with an increased occurrence of low and very low birth weight, stillbirth, early neonatal death, admission to the neonatal ICU, a prolonged maternal postpartum hospital stay and Caesarean section. CONCLUSION: Women who survive the serious conditions described could be pragmatically considered cases of maternal near miss. Interventions to reduce maternal and perinatal mortality should target women in these high-risk categories.read more
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Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study
Togoobaatar Ganchimeg,Erika Ota,Naho Morisaki,Malinee Laopaiboon,Pisake Lumbiganon,Jian Zhang,B Yamdamsuren,Marleen Temmerman,Lale Say,Ö Tunçalp,Joshua P. Vogel,Joshua P. Vogel,João Paulo Souza,Rintaro Mori +13 more
TL;DR: To investigate the risk of adverse pregnancy outcomes among adolescents in 29 countries, a large number of countries and territories are considered to be at risk.
Journal ArticleDOI
Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health): a cross-sectional study
João Paulo Souza,Ahmet Metin Gülmezoglu,Joshua P. Vogel,Guillermo Carroli,Pisake Lumbiganon,Zahida Qureshi,Maria José Costa,Bukola Fawole,Yvonne Mugerwa,Idi Nafiou,Isilda Neves,Jean José Wolomby-Molondo,Hoang Thi Bang,Kannitha Cheang,Kang Chuyun,Kapila Jayaratne,Chandani Anoma Jayathilaka,Syeda Batool Mazhar,Rintaro Mori,Mir Lais Mustafa,Laxmi Raj Pathak,Deepthi Perera,Tung Rathavy,Zenaida Dy Recidoro,Malabika Roy,P. Ruyan,N Shrestha,Surasak Taneepanichsku,Nguyen Viet Tien,Togoobaatar Ganchimeg,Mira A. Wehbe,Buyanjargal Yadamsuren,Wang Yan,Khalid Yunis,Vicente Bataglia,José Guilherme Cecatti,Bernardo Hernández-Prado,Juan Manuel Nardin,Alberto Narváez,Eduardo Ortiz-Panozo,Ricardo Pérez-Cuevas,Eliette Valladares,Nelly Zavaleta,Anthony Armson,Caroline A Crowther,Carol J. R. Hogue,Gunilla Lindmark,Suneeta Mittal,Robert Clive Pattinson,Mary Ellen Stanton,Liana Campodonico,Cristina Beatriz Cuesta,Daniel Giordano,N. Intarut,Malinee Laopaiboon,Rajiv Bahl,Jose Martines,Matthews Mathai,Mario Merialdi,Lale Say +59 more
TL;DR: High coverage of essential interventions did not imply reduced maternal mortality in the health-care facilities the authors studied, and the maternal severity index (MSI) had good accuracy for maternal death prediction in women with markers of organ dysfunction.
Journal ArticleDOI
Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data.
Jiangfeng Ye,Jiangfeng Ye,Jian Zhang,Rafael T. Mikolajczyk,Torloni,Ahmet Metin Gülmezoglu,Ana Pilar Betrán +6 more
TL;DR: All available caesarean section rates worldwide at the country level are compiled to identify the appropriate caesAREan section rate at the population level associated with the minimal maternal and neonatal mortality.
Journal ArticleDOI
The WHO Maternal Near-Miss Approach and the Maternal Severity Index Model (MSI): Tools for Assessing the Management of Severe Maternal Morbidity
João Paulo Souza,José Guilherme Cecatti,Samira M. Haddad,Mary Angela Parpinelli,Maria Laura Costa,Leila Katz,Lale Say +6 more
TL;DR: The maternal severity index (MSI) model was developed and found to able to describe the relationship between life-threatening conditions and mortality and can be used as a tool for benchmarking the performance of health services managing women with severe maternal complications and provide case-mix adjustment.
Journal ArticleDOI
Maternal and Perinatal Outcomes of Twin Pregnancy in 23 Low- and Middle-Income Countries
Joshua P. Vogel,Maria Regina Torloni,Armando Seuc,Ana Pilar Betrán,Mariana Widmer,João Paulo Souza,Mario Merialdi +6 more
TL;DR: Twin pregnancy is a significant risk factor for maternal and perinatal morbidity and mortality in low-resource settings; maternal risk and access to safe caesarean section may determine safest mode of delivery in LMICs.
References
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Journal ArticleDOI
Diagnostic tests 4: likelihood ratios
TL;DR: Likelihood ratios are alternative statistics for summarising diagnostic accuracy, which have several particularly powerful properties that make them more useful clinically than other statistics.
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Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America
José Villar,Eliette Valladares,Daniel Wojdyla,Nelly Zavaleta,Guillermo Carroli,Alejandro Velazco,Archana Shah,Liana Campodonico,Vicente Bataglia,Anibal Faundes,Ana Langer,Alberto Narváez,Allan Donner,Mariana Romero,Sofia Reynoso,Karla Simônia de Pádua,Daniel Giordano,Marius Kublickas,Arnaldo Acosta +18 more
TL;DR: In this paper, the association between caesarean delivery and pregnancy outcome at the institutional level, adjusting for the pregnant population and institutional characteristics, was assessed for the 2005 WHO global survey on maternal and perinatal health, comprising 24 geographic regions in eight countries in Latin America.
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Maternal near miss--towards a standard tool for monitoring quality of maternal health care.
TL;DR: The practical implementation of maternal near miss concept should provide an important contribution to improving quality of obstetric care to reduce maternal deaths and improve maternal health.
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Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study
José Villar,Guillermo Carroli,Nelly Zavaleta,Allan Donner,Daniel Wojdyla,Anibal Faundes,Alejandro Velazco,Vicente Bataglia,Ana Langer,Alberto Narváez,Eliette Valladares,Archana Shah,Liana Campodonico,Mariana Romero,Sofia Reynoso,Karla Simônia de Pádua,Daniel Giordano,Marius Kublickas,Arnaldo Acosta +18 more
TL;DR: Caesarean delivery independently reduces overall risk in breech presentations and risk of intrapartum fetal death in cephalic presentations but increases the risk of severe maternal and neonatal morbidity and mortality in cEPhalic presentation.