Serena Donati1, Sabrina Senatore, Alessandra Ronconi. 1. National Centre for Epidemiology, Surveillance, and Health Promotion, Istituto Superiore di Sanità-Italian National Institute of Health, Rome, Italy. serena.donati@iss.it
Abstract
OBJECTIVE: Maternal near-miss defines a narrow category of morbidity encompassing potentially life-threatening episodes. The purpose of this study was to detect near-miss instances among women admitted to intensive care units or coronary units, analyze associated causes, and compute absolute and specific maternal morbidity rates in six Italian regions. DESIGN: Observational retrospective study. SETTING: Six Italian regions representing 49% of all resident Italian women aged 15-49 years. POPULATION: The study population included all pregnant women aged 15-49 years admitted to intensive care units or coronary care units in the participating regions. Cases were defined as women aged 15-49 years resident in the participating regions, with one or more hospitalizations in intensive care for pregnancy or any pregnancy outcome between 2004 and 2005. METHODS: Cases were identified through the Hospital Discharge Database. Enrolled cases were diagnosed according to the 9(th) International Classification of Diseases. MAIN OUTCOME MEASURE: Maternal near-miss rate (number of women experiencing an admission to intensive care units/all women with live or stillborn babies). RESULTS: A total of 1259 near-miss cases were identified and the total maternal near-miss rate was 2.0/1000 deliveries. Seventy percent of the women were admitted to intensive care units or coronary units after a cesarean section. The leading associated risk factors were obstetric hemorrhage/disseminated intravascular coagulation (40%) and hypertensive disorders of pregnancy (29%). CONCLUSIONS: Monitoring of near-miss morbidity in conjunction with mortality surveillance could help to identify effective preventive measures for potentially life-threatening episodes.
OBJECTIVE: Maternal near-miss defines a narrow category of morbidity encompassing potentially life-threatening episodes. The purpose of this study was to detect near-miss instances among women admitted to intensive care units or coronary units, analyze associated causes, and compute absolute and specific maternal morbidity rates in six Italian regions. DESIGN: Observational retrospective study. SETTING: Six Italian regions representing 49% of all resident Italian women aged 15-49 years. POPULATION: The study population included all pregnant women aged 15-49 years admitted to intensive care units or coronary care units in the participating regions. Cases were defined as women aged 15-49 years resident in the participating regions, with one or more hospitalizations in intensive care for pregnancy or any pregnancy outcome between 2004 and 2005. METHODS: Cases were identified through the Hospital Discharge Database. Enrolled cases were diagnosed according to the 9(th) International Classification of Diseases. MAIN OUTCOME MEASURE: Maternal near-miss rate (number of women experiencing an admission to intensive care units/all women with live or stillborn babies). RESULTS: A total of 1259 near-miss cases were identified and the total maternal near-miss rate was 2.0/1000 deliveries. Seventy percent of the women were admitted to intensive care units or coronary units after a cesarean section. The leading associated risk factors were obstetric hemorrhage/disseminated intravascular coagulation (40%) and hypertensive disorders of pregnancy (29%). CONCLUSIONS: Monitoring of near-miss morbidity in conjunction with mortality surveillance could help to identify effective preventive measures for potentially life-threatening episodes.
Authors: Samira Maerrawi Haddad; Jose Guilherme Cecatti; Joao Paulo Souza; Maria Helena Sousa; Mary Angela Parpinelli; Maria Laura Costa; Rodolfo C Pacagnella; Ione R Brum; Olímpio B Moraes Filho; Francisco E Feitosa; Carlos A Menezes; Everardo M Guanabara; Joaquim L Moreira; Frederico A Peret; Luiza E Schmaltz; Leila Katz; Antonio C Barbosa Lima; Melania M Amorim; Marilia G Martins; Denis J Nascimento; Cláudio S Paiva; Roger D Rohloff; Sergio M Costa; Adriana G Luz; Gustavo Lobato; Eduardo Cordioli; Jose C Peraçoli; Nelson L Maia Filho; Silvana M Quintana; Fátima A Lotufo; Carla B Andreucci; Márcia M Aquino; Rosiane Mattar Journal: Biomed Res Int Date: 2014-07-24 Impact factor: 3.411
Authors: Elard Koch; Monique Chireau; Fernando Pliego; Joseph Stanford; Sebastian Haddad; Byron Calhoun; Paula Aracena; Miguel Bravo; Sebastián Gatica; John Thorp Journal: BMJ Open Date: 2015-02-23 Impact factor: 2.692
Authors: Helen L Barrett; Ruth Devin; Sophie Clarke; Marloes Dekker Nitert; Robert Boots; Narelle Fagermo; Leonie K Callaway; Karin Lust Journal: Obstet Med Date: 2012-11-05