OBJECTIVE: Our objective was to identify the frequency, causes, and avoidable factors of severe acute maternal morbidity (SAMM) in four non-specialist hospitals in rural South Africa. METHOD: We conducted a prospective audit using criteria for SAMM suited to the diagnostic and treatment facilities available in the primary hospital setting. For each case of SAMM, a local audit team assessed the standard of care against local management guidelines and examined avoidable factors. An external specialist also retrospectively examined avoidable factors. RESULT: The facility-based incidence of SAMM was 541 cases per 100,000 births (95% CI 368-767). The commonest organ systems involved were cerebral (42%), coagulation (19%), and vascular dysfunctions (16%). The commonest obstetric diagnoses were eclampsia (39%) and obstetric haemorrhage (32%). Approximately 65% of cases were avoidable. CONCLUSION: A qualitative case review audit of SAMM in a non-specialist rural setting appears feasible and sustainable, and provides valuable information towards improving deficiencies in maternal care.
OBJECTIVE: Our objective was to identify the frequency, causes, and avoidable factors of severe acute maternal morbidity (SAMM) in four non-specialist hospitals in rural South Africa. METHOD: We conducted a prospective audit using criteria for SAMM suited to the diagnostic and treatment facilities available in the primary hospital setting. For each case of SAMM, a local audit team assessed the standard of care against local management guidelines and examined avoidable factors. An external specialist also retrospectively examined avoidable factors. RESULT: The facility-based incidence of SAMM was 541 cases per 100,000 births (95% CI 368-767). The commonest organ systems involved were cerebral (42%), coagulation (19%), and vascular dysfunctions (16%). The commonest obstetric diagnoses were eclampsia (39%) and obstetric haemorrhage (32%). Approximately 65% of cases were avoidable. CONCLUSION: A qualitative case review audit of SAMM in a non-specialist rural setting appears feasible and sustainable, and provides valuable information towards improving deficiencies in maternal care.
Authors: Evan M Bloch; Charlotte Ingram; Jennifer Hull; Susan Fawcus; John Anthony; Randolph Green-Thompson; Robert L Crookes; Solomuzi Ngcobo; Darryl V Creel; Lauren Courtney; Greg R M Bellairs; Edward L Murphy Journal: Transfusion Date: 2018-07-10 Impact factor: 3.157
Authors: Evan M Bloch; Robert L Crookes; Jennifer Hull; Sue Fawcus; Rajesh Gangaram; John Anthony; Charlotte Ingram; Solomuzi Ngcobo; Julie Croxford; Darryl V Creel; Edward L Murphy Journal: Transfusion Date: 2015-03-16 Impact factor: 3.157
Authors: Lauren A V Orenstein; Evan W Orenstein; Ibrahima Teguete; Mamoudou Kodio; Milagritos Tapia; Samba O Sow; Myron M Levine Journal: PLoS One Date: 2012-10-04 Impact factor: 3.240
Authors: Shegufta S Sikder; Alain B Labrique; Barkat Ullah; Sucheta Mehra; Mahbubur Rashid; Hasmot Ali; Nusrat Jahan; Abu A Shamim; Keith P West; Parul Christian Journal: BMC Womens Health Date: 2012-08-15 Impact factor: 2.809
Authors: Shegufta S Sikder; Alain B Labrique; Barkat Ullah; Hasmot Ali; Mahbubur Rashid; Sucheta Mehra; Nusrat Jahan; Abu A Shamim; Keith P West; Parul Christian Journal: BMC Pregnancy Childbirth Date: 2011-10-21 Impact factor: 3.007