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Int J Gynaecol Obstet. 2009 Jun;105(3):252-6. doi: 10.1016/j.ijgo.2009.01.025. Epub 2009 Apr 1.

Factors associated with maternal death in women admitted to an intensive care unit with severe maternal morbidity.

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  • 1Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.

Abstract

OBJECTIVE:

To identify factors associated with maternal death among women with severe maternal morbidity.

METHODS:

A retrospective study of 673 women admitted to an obstetric intensive care unit was undertaken. The odds ratios (OR) and 95% confidence intervals (95% CI) were calculated for selected characteristics. The maternal mortality and severe maternal morbidity ratios were determined for groups of complications according to outcome (death or survival).

RESULTS:

The risk of maternal death was higher among adolescents (OR 3.3; 95% CI, 1-9.7) and patients referred from other hospitals (OR 9.8; 95% CI, 2.7-53.3). The severe maternal morbidity ratio was 46.6 per 1000 deliveries and the mortality:morbidity ratio 1:37.4. Obstetric complications led to 65.8% of admissions and 50% of maternal deaths. The number of interventions/procedures and total maximum sequential organ failure assessment score were higher in cases of death.

CONCLUSION:

The strong association between interhospital transfer and maternal death suggests delays in diagnosis, management, and referral. Adopting organ dysfunction-based criteria may contribute toward identifying the most severe cases.

PMID:
19342049
[PubMed - indexed for MEDLINE]
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