Caracterización de la muerte materna en la provincia de Chimborazo 2013 ­ 2017 / Characterization of maternal mortality in the province of Chimborazo 2013 - 2017

Introducción: la muerte materna es un indicador que permite medir el desarrollo social de un país, y tiene un gran impacto a nivel familiar y social. Objetivo: el presente estudio caracteriza las muertes maternas ocurridas en la provincia de Chimborazo desde el 2013 al 2017, con la finalidad de que los resultados contribuyan al diseño de estrategias y actividades que permitan mejorar este indicador negativo. Metodología: se partió de la información entregada por el proceso de Vigilancia de la Salud Pública de la Coordinación Zonal de Salud 3, así como de los datos del Instituto Nacional de Estadísticas y Censos (INEC) sobre nacidos vivos en los años de estudio. Se consideró sólo las muertes maternas directas. Resultados: las principales causas de muerte materna se deben a hemorragia, trastornos hipertensivos del embarazo y sepsis. Se presentan con más frecuencia en instituciones de salud, población indígena y rural, relacionadas con la primera y tercera demora. Conclusiones: realizar capacitaciones permanentes de los profesionales de los establecimientos, así como en la comunidad para que se reconozcan oportunamente los signos de peligro.

Maternal mortality in Jamaica.

A confidential inquiry into all maternal deaths in Jamaica during 3 years (1981 to 1983) was carried out. 192 maternal deaths were identified by a variety of means. The maternal mortality rate of 10.8 per 10 000 live births was considerably higher than the official rate of 4.8. The most common causes of death were hypertensive diseases of pregnancy (26%), haemorrhage (20%), ectopic pregnancy (10%), pulmonary embolus (8%), and sepsis (8%). Maternal mortality was closely related to both age and parity. The lowest rates were for women of para 2-4 aged 20-24 years and para 3-4 aged 25-29 years. The largest groups of avoidable factors were: non-use of and deficiencies in antenatal care; inadequacy in ensuring the delivery in hospital of women at high risk; and delays in taking action when signs of complications developed before, during, and after delivery.

PIP: This article reports the results of a review of all maternal deaths occurring in Jamaica in 1981-83. A total of 192 maternal deaths were identified, yielding a maternal mortality rate of 10.8/10,000 live births, which was considerably higher than the official rate of 4.8. 15% of these deaths were associated with abortion or ectopic pregnancy. The most common causes of death were hypertensive diseases of pregnancy (26%), hemorrhage (20%), ectopic pregnancy (10%), pulmonary embolus (8%), and sepsis (8%). Maternal mortality was closely related to both age and parity. Lowest rates were noted among women of para 2-4 aged 20-24 years and para 3-4 aged 25-29 years. Avoidable factors were judged to be present in 68% of the deaths. The largest categories of avoidable factors were: nonuse of and deficiencies in antenatal care; inadequacy in ensuring the delivery in hospital of high-risk women; and delays in taking action when signs of complications developed before, during, and after delivery. In response to these findings, the Ministry of Health's Maternal Mortality Committee has called for the following actions: measures to encourage women to seek antenatal care early in pregnancy; improvements in antenatal monitoring; the referral of high-risk women for hospital delivery; the definition of standard procedures for dealing with specific complications of pregnancy, e.g., eclampsia and hemorrhage; regionalization of obstetric services and criteria for referring patients to hospital; and review of provision of blood and plasma for emergency transfusions.

[Maternal mortality at the Hospital Central Militar]. / Mortalidad materna en el Hospital Central Militar.

PIP: 71 maternal deaths at the Hospital Central Militar (Central Military Hospital) over the 12-year period 1968-1979 were reviewed. Maternal mortality rate was 23.07% which is higher than for the rest of the population. The most frequent type of mortality was due to obstetrical causes (69.01%) and here it was infection, pre-eclampsia, eclampsia, and hemorrhage which were most frequent. Among nonobstetrical causes, viral hepatitis was the most frequent. Death occurred more often among young women ages 21-25 with 2-4 previous deliveries. Death was considered evitable and probably evitable in 50 cases (70.42%). Of these, 62% were the responsibility of physicians and hospitals, while the rest were attributable to the patient and the community. (author's modified)^ieng