OBJECTIVE: To assess the most commonly employed diagnostic indicators of severe maternal morbidity (obstetric near-miss). METHODS: Review of the literature from January 1989 to August 2008. RESULTS: Fifty-one manuscripts met the eligibility criteria, and 96 indicators were utilized at least once. Admission to intensive care unit (n = 28 studies) was the indicator most frequently utilized, followed by eclampsia and hemorrhage (n = 27), blood transfusion (n = 26) and emergent hysterectomy (n = 24). CONCLUSION: Considering these findings, a trial version of a 13-item instrument for diagnosing obstetric near-miss is proposed. It includes the indicators eclampsia, severe hypertension, pulmonary edema, cardiac arrest, obstetrical hemorrhage, uterine rupture, admission to intensive care unit, emergent hysterectomy, blood transfusion, anesthetic accidents, urea >15 mmol/l or creatinine >400 mmol/l, oliguria (<400 ml/24 h) and coma. Further studies should focus on consensual definitions for these indicators and evaluate the psychometric proprieties of this trial version.
OBJECTIVE: To assess the most commonly employed diagnostic indicators of severe maternal morbidity (obstetric near-miss). METHODS: Review of the literature from January 1989 to August 2008. RESULTS: Fifty-one manuscripts met the eligibility criteria, and 96 indicators were utilized at least once. Admission to intensive care unit (n = 28 studies) was the indicator most frequently utilized, followed by eclampsia and hemorrhage (n = 27), blood transfusion (n = 26) and emergent hysterectomy (n = 24). CONCLUSION: Considering these findings, a trial version of a 13-item instrument for diagnosing obstetric near-miss is proposed. It includes the indicators eclampsia, severe hypertension, pulmonary edema, cardiac arrest, obstetrical hemorrhage, uterine rupture, admission to intensive care unit, emergent hysterectomy, blood transfusion, anesthetic accidents, urea >15 mmol/l or creatinine >400 mmol/l, oliguria (<400 ml/24 h) and coma. Further studies should focus on consensual definitions for these indicators and evaluate the psychometric proprieties of this trial version.
Authors: Tabassum Firoz; Doris Chou; Peter von Dadelszen; Priya Agrawal; Rachel Vanderkruik; Ozge Tunçalp; Laura A Magee; Nynke van Den Broek; Lale Say Journal: Bull World Health Organ Date: 2013-08-06 Impact factor: 9.408
Authors: Shannon A McMahon; Asha S George; Joy J Chebet; Idda H Mosha; Rose N M Mpembeni; Peter J Winch Journal: BMC Pregnancy Childbirth Date: 2014-08-12 Impact factor: 3.007