Factors associated with severe morbidity and maternal near miss in tertiary centre of attention to maternal and newborn
Autor(a) principal: | |
---|---|
Data de Publicação: | 2016 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFC |
Texto Completo: | http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=16482 |
Resumo: | A pregnancy can be composed of a range of clinical conditions, ranging from a healthy pregnancy to another limit that is maternal death. Between these two extremes are the conditions described as severe maternal morbidity and near miss, which is a more severe condition than the maternal morbidity. In 2009, the WHO standardized maternal near miss approach, as an important tool to uniformly identify cases and evaluate the quality of care for women with serious complications. It is worth emphasizing that women who fall into these situations share many characteristics with maternal deaths, but represent a rich source of details about the determinant factors of their maternal health condition, since they are alive. Participated in this research 941 women who had severe maternal morbidity criteria and/or near miss during the period of July 2009 to June 2010, at the Maternity School Assis Chateaubriand - UFC. They were identified 61 cases of maternal near miss and 880 of severe maternal morbidity non-near miss. The incidence of maternal morbidity non-near miss was 190.6 and near miss was 10.8/1,000 live births. The mortality rate of maternal near miss was 18%. The variables significantly different between the two groups were: color (p = 0.002) and number of prenatal visits (p <0.001). Among the severe maternal morbidity conditions, it was found that eclampsia and the need for ICU admission were the defining of the risk of progressing to death, while the use of magnesium sulfate acted as a protective factor. It was found, also, that have criteria of near miss is statistically significant for maternal death (p <0.001; ORB = 3.94; 95% CI: 1.66 - 9.37). Among the defining criteria of near miss, the more directly associated with maternal death was the presence of management criteria: all the 11 cases that resulted in death had some management discretion. It was concluded that based health policies and actions in cases of maternal near miss is the most effective means of improving maternal health. |
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info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisFactors associated with severe morbidity and maternal near miss in tertiary centre of attention to maternal and newbornFatores associados à morbidade grave e near miss materno em centro terciÃrio de atenÃÃo à saÃde materna e neonatal2016-01-12Francisco HerlÃnio Costa Carvalho44307110382http://buscatextual.cnpq.br/buscatextual/visualizacv.jsp?id=K4775406T6Raimunda Hermelinda Maia Macena41449070310HelvÃcio Neves Feitosa16335015315http://buscatextual.cnpq.br/buscatextual/visualizacv.jsp?id=K4710238Y5Francisco Edson de Lucena Feitosa2473482934902064823379http://lattes.cnpq.br/9131583223256994Hesly Martins Pereira LimaUniversidade Federal do CearÃPrograma de PÃs-GraduaÃÃo em SaÃde PÃblicaUFCBRSAUDE PUBLICAA pregnancy can be composed of a range of clinical conditions, ranging from a healthy pregnancy to another limit that is maternal death. Between these two extremes are the conditions described as severe maternal morbidity and near miss, which is a more severe condition than the maternal morbidity. In 2009, the WHO standardized maternal near miss approach, as an important tool to uniformly identify cases and evaluate the quality of care for women with serious complications. It is worth emphasizing that women who fall into these situations share many characteristics with maternal deaths, but represent a rich source of details about the determinant factors of their maternal health condition, since they are alive. Participated in this research 941 women who had severe maternal morbidity criteria and/or near miss during the period of July 2009 to June 2010, at the Maternity School Assis Chateaubriand - UFC. They were identified 61 cases of maternal near miss and 880 of severe maternal morbidity non-near miss. The incidence of maternal morbidity non-near miss was 190.6 and near miss was 10.8/1,000 live births. The mortality rate of maternal near miss was 18%. The variables significantly different between the two groups were: color (p = 0.002) and number of prenatal visits (p <0.001). Among the severe maternal morbidity conditions, it was found that eclampsia and the need for ICU admission were the defining of the risk of progressing to death, while the use of magnesium sulfate acted as a protective factor. It was found, also, that have criteria of near miss is statistically significant for maternal death (p <0.001; ORB = 3.94; 95% CI: 1.66 - 9.37). Among the defining criteria of near miss, the more directly associated with maternal death was the presence of management criteria: all the 11 cases that resulted in death had some management discretion. It was concluded that based health policies and actions in cases of maternal near miss is the most effective means of improving maternal health.Uma gravidez pode ser constituida por uma gama de condiÃÃes clÃnicas, que vÃo desde uma gravidez saudÃvel atà o outro limite que à a morte materna. Entre os extremos encontram-se as condiÃÃes descritas como morbidade materna grave e near miss, que à uma condiÃÃo mais grave do que a morbidade materna. Em 2009, a OMS padronizou a abordagem near miss materno, como uma ferramenta importante para identificar uniformemente os casos e avaliar a qualidade dos cuidados prestados Ãs mulheres com complicaÃÃes graves. Vale enfatizar, que as mulheres que se enquadram nestas situaÃÃes compartilham muitas caracterÃsticas com os Ãbitos maternos, porÃm representam uma fonte rica de detalhes acerca dos fatores determinantes da sua condiÃÃo de saÃde materna, uma vez que estas estÃo vivas. Participaram da presente pesquisa 941 mulheres que possuÃam critÃrios de morbidade materna grave e/ou near miss durante o perÃodo de julho de 2009 a junho de 2010, na Maternidade-Escola Assis Chateaubriand-UFC. Foram identificados 61 casos de near miss materno e 880 de morbidade materna grave nÃo-near miss. A incidÃncia de morbidade materna nÃo-near miss foi de 190,6 e near miss foi de 10,8/1.000 nascidos vivos. A taxa de mortalidade de near miss materno foi de 18%. As variÃveis significativamente diferente entre os dois grupos foram: cor (p=0,002) e nÃmero de consultas de prÃ-natal (p<0,001). Dentre as condiÃÃes de morbidade materna grave, verificou-se que a eclÃmpsia e a necessidade de internaÃÃo em UTI foram os definidores do risco de evoluir ao Ãbito, enquanto a utilizaÃÃo do sulfato de magnÃsio atuou como fator de proteÃÃo. Constatou-se que ter critÃrio de near miss à estatisticamente siginificante para a morte materna (p < 0,001; ORB= 3,94; IC95%:1,66-9,37). Entre os critÃrios definidores de near miss, o mais diretamente associado ao Ãbito materno foi à presenÃa de critÃrios de manejo: todos os 11 casos que culminaram em Ãbito apresentaram algum critÃrio de manejo. Concluiu-se que basear polÃticas e aÃÃes de saÃde nos casos de near miss materno à o meio mais eficaz de melhorar a saÃde materna.nÃo hÃhttp://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=16482application/pdfinfo:eu-repo/semantics/openAccessporreponame:Biblioteca Digital de Teses e Dissertações da UFCinstname:Universidade Federal do Cearáinstacron:UFC2019-01-21T11:29:50Zmail@mail.com - |
dc.title.en.fl_str_mv |
Factors associated with severe morbidity and maternal near miss in tertiary centre of attention to maternal and newborn |
dc.title.alternative.pt.fl_str_mv |
Fatores associados à morbidade grave e near miss materno em centro terciÃrio de atenÃÃo à saÃde materna e neonatal |
title |
Factors associated with severe morbidity and maternal near miss in tertiary centre of attention to maternal and newborn |
spellingShingle |
Factors associated with severe morbidity and maternal near miss in tertiary centre of attention to maternal and newborn Hesly Martins Pereira Lima SAUDE PUBLICA |
title_short |
Factors associated with severe morbidity and maternal near miss in tertiary centre of attention to maternal and newborn |
title_full |
Factors associated with severe morbidity and maternal near miss in tertiary centre of attention to maternal and newborn |
title_fullStr |
Factors associated with severe morbidity and maternal near miss in tertiary centre of attention to maternal and newborn |
title_full_unstemmed |
Factors associated with severe morbidity and maternal near miss in tertiary centre of attention to maternal and newborn |
title_sort |
Factors associated with severe morbidity and maternal near miss in tertiary centre of attention to maternal and newborn |
author |
Hesly Martins Pereira Lima |
author_facet |
Hesly Martins Pereira Lima |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Francisco HerlÃnio Costa Carvalho |
dc.contributor.advisor1ID.fl_str_mv |
44307110382 |
dc.contributor.advisor1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.jsp?id=K4775406T6 |
dc.contributor.referee1.fl_str_mv |
Raimunda Hermelinda Maia Macena |
dc.contributor.referee1ID.fl_str_mv |
41449070310 |
dc.contributor.referee2.fl_str_mv |
HelvÃcio Neves Feitosa |
dc.contributor.referee2ID.fl_str_mv |
16335015315 |
dc.contributor.referee2Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.jsp?id=K4710238Y5 |
dc.contributor.referee3.fl_str_mv |
Francisco Edson de Lucena Feitosa |
dc.contributor.referee3ID.fl_str_mv |
24734829349 |
dc.contributor.authorID.fl_str_mv |
02064823379 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/9131583223256994 |
dc.contributor.author.fl_str_mv |
Hesly Martins Pereira Lima |
contributor_str_mv |
Francisco HerlÃnio Costa Carvalho Raimunda Hermelinda Maia Macena HelvÃcio Neves Feitosa Francisco Edson de Lucena Feitosa |
dc.subject.cnpq.fl_str_mv |
SAUDE PUBLICA |
topic |
SAUDE PUBLICA |
dc.description.sponsorship.fl_txt_mv |
nÃo hà |
dc.description.abstract.por.fl_txt_mv |
A pregnancy can be composed of a range of clinical conditions, ranging from a healthy pregnancy to another limit that is maternal death. Between these two extremes are the conditions described as severe maternal morbidity and near miss, which is a more severe condition than the maternal morbidity. In 2009, the WHO standardized maternal near miss approach, as an important tool to uniformly identify cases and evaluate the quality of care for women with serious complications. It is worth emphasizing that women who fall into these situations share many characteristics with maternal deaths, but represent a rich source of details about the determinant factors of their maternal health condition, since they are alive. Participated in this research 941 women who had severe maternal morbidity criteria and/or near miss during the period of July 2009 to June 2010, at the Maternity School Assis Chateaubriand - UFC. They were identified 61 cases of maternal near miss and 880 of severe maternal morbidity non-near miss. The incidence of maternal morbidity non-near miss was 190.6 and near miss was 10.8/1,000 live births. The mortality rate of maternal near miss was 18%. The variables significantly different between the two groups were: color (p = 0.002) and number of prenatal visits (p <0.001). Among the severe maternal morbidity conditions, it was found that eclampsia and the need for ICU admission were the defining of the risk of progressing to death, while the use of magnesium sulfate acted as a protective factor. It was found, also, that have criteria of near miss is statistically significant for maternal death (p <0.001; ORB = 3.94; 95% CI: 1.66 - 9.37). Among the defining criteria of near miss, the more directly associated with maternal death was the presence of management criteria: all the 11 cases that resulted in death had some management discretion. It was concluded that based health policies and actions in cases of maternal near miss is the most effective means of improving maternal health. Uma gravidez pode ser constituida por uma gama de condiÃÃes clÃnicas, que vÃo desde uma gravidez saudÃvel atà o outro limite que à a morte materna. Entre os extremos encontram-se as condiÃÃes descritas como morbidade materna grave e near miss, que à uma condiÃÃo mais grave do que a morbidade materna. Em 2009, a OMS padronizou a abordagem near miss materno, como uma ferramenta importante para identificar uniformemente os casos e avaliar a qualidade dos cuidados prestados Ãs mulheres com complicaÃÃes graves. Vale enfatizar, que as mulheres que se enquadram nestas situaÃÃes compartilham muitas caracterÃsticas com os Ãbitos maternos, porÃm representam uma fonte rica de detalhes acerca dos fatores determinantes da sua condiÃÃo de saÃde materna, uma vez que estas estÃo vivas. Participaram da presente pesquisa 941 mulheres que possuÃam critÃrios de morbidade materna grave e/ou near miss durante o perÃodo de julho de 2009 a junho de 2010, na Maternidade-Escola Assis Chateaubriand-UFC. Foram identificados 61 casos de near miss materno e 880 de morbidade materna grave nÃo-near miss. A incidÃncia de morbidade materna nÃo-near miss foi de 190,6 e near miss foi de 10,8/1.000 nascidos vivos. A taxa de mortalidade de near miss materno foi de 18%. As variÃveis significativamente diferente entre os dois grupos foram: cor (p=0,002) e nÃmero de consultas de prÃ-natal (p<0,001). Dentre as condiÃÃes de morbidade materna grave, verificou-se que a eclÃmpsia e a necessidade de internaÃÃo em UTI foram os definidores do risco de evoluir ao Ãbito, enquanto a utilizaÃÃo do sulfato de magnÃsio atuou como fator de proteÃÃo. Constatou-se que ter critÃrio de near miss à estatisticamente siginificante para a morte materna (p < 0,001; ORB= 3,94; IC95%:1,66-9,37). Entre os critÃrios definidores de near miss, o mais diretamente associado ao Ãbito materno foi à presenÃa de critÃrios de manejo: todos os 11 casos que culminaram em Ãbito apresentaram algum critÃrio de manejo. Concluiu-se que basear polÃticas e aÃÃes de saÃde nos casos de near miss materno à o meio mais eficaz de melhorar a saÃde materna. |
description |
A pregnancy can be composed of a range of clinical conditions, ranging from a healthy pregnancy to another limit that is maternal death. Between these two extremes are the conditions described as severe maternal morbidity and near miss, which is a more severe condition than the maternal morbidity. In 2009, the WHO standardized maternal near miss approach, as an important tool to uniformly identify cases and evaluate the quality of care for women with serious complications. It is worth emphasizing that women who fall into these situations share many characteristics with maternal deaths, but represent a rich source of details about the determinant factors of their maternal health condition, since they are alive. Participated in this research 941 women who had severe maternal morbidity criteria and/or near miss during the period of July 2009 to June 2010, at the Maternity School Assis Chateaubriand - UFC. They were identified 61 cases of maternal near miss and 880 of severe maternal morbidity non-near miss. The incidence of maternal morbidity non-near miss was 190.6 and near miss was 10.8/1,000 live births. The mortality rate of maternal near miss was 18%. The variables significantly different between the two groups were: color (p = 0.002) and number of prenatal visits (p <0.001). Among the severe maternal morbidity conditions, it was found that eclampsia and the need for ICU admission were the defining of the risk of progressing to death, while the use of magnesium sulfate acted as a protective factor. It was found, also, that have criteria of near miss is statistically significant for maternal death (p <0.001; ORB = 3.94; 95% CI: 1.66 - 9.37). Among the defining criteria of near miss, the more directly associated with maternal death was the presence of management criteria: all the 11 cases that resulted in death had some management discretion. It was concluded that based health policies and actions in cases of maternal near miss is the most effective means of improving maternal health. |
publishDate |
2016 |
dc.date.issued.fl_str_mv |
2016-01-12 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
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http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=16482 |
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http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=16482 |
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por |
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Universidade Federal do Cearà |
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Programa de PÃs-GraduaÃÃo em SaÃde PÃblica |
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UFC |
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BR |
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Universidade Federal do Cearà |
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reponame:Biblioteca Digital de Teses e Dissertações da UFC instname:Universidade Federal do Ceará instacron:UFC |
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