Priorities in emergency obstetric care in Bolivia--maternal mortality and near-miss morbidity in metropolitan La Paz
(2009) In BJOG: An International Journal of Obstetrics & Gynaecology 116(9). p.1210-1217- Abstract
- Objective To document the frequency and causes of maternal mortality and severe (near-miss) morbidity in metropolitan La Paz, Bolivia. Design Facility-based cross-sectional study. Setting Four maternity hospitals in La Paz and El Alto, Bolivia, where free maternal health care is provided through a government-subsidised programme. Population All maternal deaths and women with near-miss morbidity. Methods Inclusion of near-miss using clinical and management-based criteria. Main outcome measures Maternal mortality ratio (MMR), severe morbidity ratio (SMR), mortality indices and proportion of near-miss cases at hospital admission. Results MMR was 187/100 000 live births and SMR was 50/1000 live births, with a relatively low mortality index of... (More)
- Objective To document the frequency and causes of maternal mortality and severe (near-miss) morbidity in metropolitan La Paz, Bolivia. Design Facility-based cross-sectional study. Setting Four maternity hospitals in La Paz and El Alto, Bolivia, where free maternal health care is provided through a government-subsidised programme. Population All maternal deaths and women with near-miss morbidity. Methods Inclusion of near-miss using clinical and management-based criteria. Main outcome measures Maternal mortality ratio (MMR), severe morbidity ratio (SMR), mortality indices and proportion of near-miss cases at hospital admission. Results MMR was 187/100 000 live births and SMR was 50/1000 live births, with a relatively low mortality index of 3.6%. Severe haemorrhage and severe hypertensive disorders were the main causes of near-miss, with 26% of severe haemorrhages occurring in early pregnancy. Sepsis was the most common cause of death. The majority of near-miss cases (74%) were in critical condition at hospital admission and differed from those fulfilling the criteria after admission as to diagnostic categories and socio-demographic variables. Conclusions Pre-hospital barriers remain to be of great importance in a setting of this type, where there is wide availability of free maternal health care. Such barriers, together with haemorrhage in early pregnancy, pre-eclampsia detection and referral patterns, should be priority areas for future research and interventions to improve maternal health. Near-miss upon arrival and near-miss after arrival at hospital should be analysed separately as that provides additional information about factors that contribute to maternal ill-health. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1462827
- author
- Roost, M. ; Altamirano, V. C. ; Liljestrand, Jerker LU and Essen, B.
- organization
- publishing date
- 2009
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- severe maternal morbidity, near-miss, Bolivia, maternal mortality
- in
- BJOG: An International Journal of Obstetrics & Gynaecology
- volume
- 116
- issue
- 9
- pages
- 1210 - 1217
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000267879700010
- scopus:68249158007
- pmid:19459864
- ISSN
- 1471-0528
- DOI
- 10.1111/j.1471-0528.2009.02209.x
- language
- English
- LU publication?
- yes
- id
- f4a5d245-e8ad-4d85-9afd-9c6c9d9fe22c (old id 1462827)
- date added to LUP
- 2016-04-01 13:22:45
- date last changed
- 2022-03-29 07:08:41
@article{f4a5d245-e8ad-4d85-9afd-9c6c9d9fe22c,
abstract = {{Objective To document the frequency and causes of maternal mortality and severe (near-miss) morbidity in metropolitan La Paz, Bolivia. Design Facility-based cross-sectional study. Setting Four maternity hospitals in La Paz and El Alto, Bolivia, where free maternal health care is provided through a government-subsidised programme. Population All maternal deaths and women with near-miss morbidity. Methods Inclusion of near-miss using clinical and management-based criteria. Main outcome measures Maternal mortality ratio (MMR), severe morbidity ratio (SMR), mortality indices and proportion of near-miss cases at hospital admission. Results MMR was 187/100 000 live births and SMR was 50/1000 live births, with a relatively low mortality index of 3.6%. Severe haemorrhage and severe hypertensive disorders were the main causes of near-miss, with 26% of severe haemorrhages occurring in early pregnancy. Sepsis was the most common cause of death. The majority of near-miss cases (74%) were in critical condition at hospital admission and differed from those fulfilling the criteria after admission as to diagnostic categories and socio-demographic variables. Conclusions Pre-hospital barriers remain to be of great importance in a setting of this type, where there is wide availability of free maternal health care. Such barriers, together with haemorrhage in early pregnancy, pre-eclampsia detection and referral patterns, should be priority areas for future research and interventions to improve maternal health. Near-miss upon arrival and near-miss after arrival at hospital should be analysed separately as that provides additional information about factors that contribute to maternal ill-health.}},
author = {{Roost, M. and Altamirano, V. C. and Liljestrand, Jerker and Essen, B.}},
issn = {{1471-0528}},
keywords = {{severe maternal morbidity; near-miss; Bolivia; maternal mortality}},
language = {{eng}},
number = {{9}},
pages = {{1210--1217}},
publisher = {{Wiley-Blackwell}},
series = {{BJOG: An International Journal of Obstetrics & Gynaecology}},
title = {{Priorities in emergency obstetric care in Bolivia--maternal mortality and near-miss morbidity in metropolitan La Paz}},
url = {{http://dx.doi.org/10.1111/j.1471-0528.2009.02209.x}},
doi = {{10.1111/j.1471-0528.2009.02209.x}},
volume = {{116}},
year = {{2009}},
}