[ { "key": "6XF7HNXU", "version": 1, "library": { "type": "group", "id": 15588, "name": "epidemiologia y salud materna", "links": { "alternate": { "href": "https://www.zotero.org/groups/epidemiologia_y_salud_materna", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/15588/items/6XF7HNXU", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/epidemiologia_y_salud_materna/items/6XF7HNXU", "type": "text/html" } }, "meta": { "createdByUser": { "id": 211505, "username": "DeniseGonzalez", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/denisegonzalez", "type": "text/html" } } }, "creatorSummary": "Reichenheim et al.", "parsedDate": "2009-09", "numChildren": 0 }, "data": { "key": "6XF7HNXU", "version": 1, "itemType": "journalArticle", "title": "Severe acute obstetric morbidity (near-miss): a review of the relative use of its diagnostic indicators", "creators": [ { "creatorType": "author", "firstName": "Michael E", "lastName": "Reichenheim" }, { "creatorType": "author", "firstName": "Flávio", "lastName": "Zylbersztajn" }, { "creatorType": "author", "firstName": "Claudia L", "lastName": "Moraes" }, { "creatorType": "author", "firstName": "Gustavo", "lastName": "Lobato" } ], "abstractNote": "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.", "publicationTitle": "Archives of Gynecology and Obstetrics", "publisher": "", "place": "", "date": "Sep 2009", "volume": "280", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "337-343", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Arch. Gynecol. Obstet", "DOI": "10.1007/s00404-008-0891-1", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19112576", "accessDate": "2010-05-07T22:57:52Z", "PMID": "", "PMCID": "", "ISSN": "1432-0711", "archive": "", "archiveLocation": "", "shortTitle": "Severe acute obstetric morbidity (near-miss)", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19112576", "tags": [ { "tag": "Acute Disease", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Health Status Indicators", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Maternal Mortality", "type": 1 }, { "tag": "Morbidity", "type": 1 }, { "tag": "Obstetric Labor Complications", "type": 1 }, { "tag": "Pregnancy", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-05-07T22:58:11Z", "dateModified": "2010-05-07T22:58:11Z" } }, { "key": "9NPJ5FF2", "version": 1, "library": { "type": "group", "id": 15588, "name": "epidemiologia y salud materna", "links": { "alternate": { "href": "https://www.zotero.org/groups/epidemiologia_y_salud_materna", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/15588/items/9NPJ5FF2", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/epidemiologia_y_salud_materna/items/9NPJ5FF2", "type": "text/html" } }, "meta": { "createdByUser": { "id": 211505, "username": "DeniseGonzalez", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/denisegonzalez", "type": "text/html" } } }, "creatorSummary": "Kaye et al.", "parsedDate": "2003-03", "numChildren": 0 }, "data": { "key": "9NPJ5FF2", "version": 1, "itemType": "journalArticle", "title": "Maternal mortality and associated near-misses among emergency intrapartum obstetric referrals in Mulago Hospital, Kampala, Uganda", "creators": [ { "creatorType": "author", "firstName": "D", "lastName": "Kaye" }, { "creatorType": "author", "firstName": "F", "lastName": "Mirembe" }, { "creatorType": "author", "firstName": "F", "lastName": "Aziga" }, { "creatorType": "author", "firstName": "B", "lastName": "Namulema" } ], "abstractNote": "BACKGROUND: Many maternal deaths (as well as related severe morbidity) are of women who do not attend antenatal care in a given health unit but are referred there when they develop life-threatening obstetric complications. OBJECTIVE: To determine the reproductive characteristics of emergency obstetric referrals, and determine the contribution of emergency obstetric referrals to severe acute maternal morbidity (near-misses) and maternal mortality. STUDY DESIGN: Descriptive cross-sectional study. SETTING: Mulago hospital, the National Referral hospital, Kampala, Uganda, from 1st March to August 30th 2000. SUBJECTS: Nine hundred and eighty three consecutive women admitted as emergency obstetric referrals in labour or puerperium. INTERVENTIONS: Subjects were followed from time of admission to discharge (or death). They were interviewed (or examined) to obtain data on socio-demographic characteristics, reproductive history, obstetric outcome of the index pregnancy, obstetric complications and cause of death. Their records were reviewed to determine evidence of severe acute morbidity from acute organ/system dysfunction, using the definition by Mantel et al. These data were analysed using the Epilnfo computer programme in terms of means, frequencies and percentages. MAIN OUTCOME MEASURES: Socio-demographic characteristics, obstetric complications, cause of deaths, cause and type of near miss mortality and case fatality rates. RESULTS: Of the 983 referrals, over 100 were near-misses and 17 died. Using the definition of Mantel et al of near-misses enabled identification of six times as many near-misses as maternal deaths. The commonest causes of death were postpartum haemorrhage and eclampsia. Low status was highly associated with both maternal deaths and near misses. CONCLUSION: In developing countries, with poor obstetric services, emergency transfers in labour are very common. These women, who are of low status, contribute significantly to maternal mortality and morbidity.", "publicationTitle": "East African Medical Journal", "publisher": "", "place": "", "date": "Mar 2003", "volume": "80", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "144-149", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "East Afr Med J", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/12762430", "accessDate": "2010-05-07T22:47:18Z", "PMID": "", "PMCID": "", "ISSN": "0012-835X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 12762430", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Cross-Sectional Studies", "type": 1 }, { "tag": "Emergency Medical Services", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Health Knowledge, Attitudes, Practice", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Maternal Mortality", "type": 1 }, { "tag": "Obstetric Labor Complications", "type": 1 }, { "tag": "Obstetrics and Gynecology Department, Hospital", "type": 1 }, { "tag": "Parity", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Puerperal Disorders", "type": 1 }, { "tag": "Referral and Consultation", "type": 1 }, { "tag": "Socioeconomic Factors", "type": 1 }, { "tag": "Survival Analysis", "type": 1 }, { "tag": "Uganda", "type": 1 }, { "tag": "Women's Rights", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-05-07T22:47:23Z", "dateModified": "2010-05-07T22:47:23Z" } }, { "key": "C53XA593", "version": 1, "library": { "type": "group", "id": 15588, "name": "epidemiologia y salud materna", "links": { "alternate": { "href": "https://www.zotero.org/groups/epidemiologia_y_salud_materna", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/15588/items/C53XA593", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/epidemiologia_y_salud_materna/items/C53XA593", "type": "text/html" } }, "meta": { "createdByUser": { "id": 211505, "username": "DeniseGonzalez", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/denisegonzalez", "type": "text/html" } } }, "creatorSummary": "Lapinsky et al.", "parsedDate": "1997-03", "numChildren": 0 }, "data": { "key": "C53XA593", "version": 1, "itemType": "journalArticle", "title": "Critical care management of the obstetric patient", "creators": [ { "creatorType": "author", "firstName": "S E", "lastName": "Lapinsky" }, { "creatorType": "author", "firstName": "K", "lastName": "Kruczynski" }, { "creatorType": "author", "firstName": "G R", "lastName": "Seaward" }, { "creatorType": "author", "firstName": "D", "lastName": "Farine" }, { "creatorType": "author", "firstName": "R F", "lastName": "Grossman" } ], "abstractNote": "PURPOSE: To review a series of critically ill obstetric patients admitted to a general intensive care unit in a Canadian centre, to assess the spectrum of diseases, interventions required and outcome. METHODS: A retrospective chart review was performed of obstetric patients admitted to the intensive care unit of an academic hospital with a high-risk obstetric service, during a five-year period. Data obtained included the admission diagnosis, ICU course and outcome. Daily APACHE II and TISS scores were recorded. RESULTS: Sixty-five obstetric patients, representing 0.26% of deliveries in this hospital, were admitted to the ICU during the study period. All had received prenatal care. Admission diagnoses included obstetric (71%) and non-obstetric (29%) complications. The mean APACHE II score was 6.8 +/- 4.2 and mean TISS score was 24 +/- 8.1. Twenty-seven patients (42%) required mechanical ventilation. No maternal mortality occurred and the perinatal mortality rate was 11%. CONCLUSIONS: A small proportion of obstetric patients develop complications requiring ICU admission. The outcome in this study was excellent, in contrast to that reported in other published studies with similar ICU admission rates. The universal availability of prenatal care may be an important factor in the outcome of this group of patients. The lack of a specific severity of illness scoring system for the pregnant patient makes comparison of case series difficult.", "publicationTitle": "Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie", "publisher": "", "place": "", "date": "Mar 1997", "volume": "44", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "325-329", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Can J Anaesth", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/9067055", "accessDate": "2010-05-07T21:55:23Z", "PMID": "", "PMCID": "", "ISSN": "0832-610X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 9067055", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Critical Care", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Intensive Care Units", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Pregnancy Complications", "type": 1 }, { "tag": "Retrospective Studies", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-05-07T21:55:47Z", "dateModified": "2010-05-07T21:55:47Z" } }, { "key": "TKIBHCBB", "version": 1, "library": { "type": "group", "id": 15588, "name": "epidemiologia y salud materna", "links": { "alternate": { "href": "https://www.zotero.org/groups/epidemiologia_y_salud_materna", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/15588/items/TKIBHCBB", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/epidemiologia_y_salud_materna/items/TKIBHCBB", "type": "text/html" } }, "meta": { "createdByUser": { "id": 211505, "username": "DeniseGonzalez", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/denisegonzalez", "type": "text/html" } } }, "creatorSummary": "Behjati et al.", "parsedDate": "2009-08", "numChildren": 0 }, "data": { "key": "TKIBHCBB", "version": 1, "itemType": "journalArticle", "title": "A near miss: lessons from a case of omental pregnancy", "creators": [ { "creatorType": "author", "firstName": "S", "lastName": "Behjati" }, { "creatorType": "author", "firstName": "J E A K", "lastName": "Bamfo" }, { "creatorType": "author", "firstName": "A W", "lastName": "Bates" }, { "creatorType": "author", "firstName": "S", "lastName": "Veerareddy" } ], "abstractNote": "", "publicationTitle": "Journal of Obstetrics and Gynaecology: The Journal of the Institute of Obstetrics and Gynaecology", "publisher": "", "place": "", "date": "Aug 2009", "volume": "29", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "559-560", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Obstet Gynaecol", "DOI": "10.1080/01443610902984946", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/Identificar factores de riesgo asociados a la presentación de complicaciones.pubmed/19697218", "accessDate": "2010-04-09T07:31:30Z", "PMID": "", "PMCID": "", "ISSN": "1364-6893", "archive": "", "archiveLocation": "", "shortTitle": "A near miss", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19697218", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Omentum", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Pregnancy, Ectopic", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-04-09T09:11:01Z", "dateModified": "2010-05-07T20:33:57Z" } }, { "key": "HXVZQHBQ", "version": 1, "library": { "type": "group", "id": 15588, "name": "epidemiologia y salud materna", "links": { "alternate": { "href": "https://www.zotero.org/groups/epidemiologia_y_salud_materna", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/15588/items/HXVZQHBQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/epidemiologia_y_salud_materna/items/HXVZQHBQ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 211505, "username": "DeniseGonzalez", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/denisegonzalez", "type": "text/html" } } }, "creatorSummary": "Souza et al.", "parsedDate": "2009-06", "numChildren": 0 }, "data": { "key": "HXVZQHBQ", "version": 1, "itemType": "journalArticle", "title": "An emerging \"maternal near-miss syndrome\": narratives of women who almost died during pregnancy and childbirth", "creators": [ { "creatorType": "author", "firstName": "Joao P", "lastName": "Souza" }, { "creatorType": "author", "firstName": "Jose G", "lastName": "Cecatti" }, { "creatorType": "author", "firstName": "Mary A", "lastName": "Parpinelli" }, { "creatorType": "author", "firstName": "Fabiana", "lastName": "Krupa" }, { "creatorType": "author", "firstName": "Maria J D", "lastName": "Osis" } ], "abstractNote": "BACKGROUND: An improvement in maternal health conditions can only be achieved when a reduction in the number of deaths is accompanied by a reduction in the frequency of severe complications of pregnancy. The objective of this study was to investigate women's experiences related to the burden of severe maternal morbidity. METHODS: This qualitative study is based on narratives of women who survived severe complications of pregnancy and who were admitted to the intensive care unit of a public university hospital in the city of Campinas, Brazil. A sample of 30 women was recruited between April 2007 and January 2008. Before hospital discharge, eligible women who agreed to participate responded to a semidirected interview. The interviews were recorded and the transcripts received a thematic analysis. RESULTS: Two major themes were identified, one more closely related to the experience of a critical illness and the other to the experience of care. A complex set of reactions was found in the women who survived, indicating the occurrence of acute stress-related disorders. CONCLUSIONS: On the basis of narratives of women who almost died during pregnancy and childbirth, we reported on an acute stress disorder that may be associated with the occurrence of severe maternal complications, which we named, the \"maternal near-miss syndrome.\" The implementation of integrated care that encompasses the physical, psychological, social, and spiritual aspects of women's health may help to alleviate the burden that maternal complications impose on millions of women around the world.", "publicationTitle": "Birth (Berkeley, Calif.)", "publisher": "", "place": "", "date": "Jun 2009", "volume": "36", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "149-158", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Birth", "DOI": "10.1111/j.1523-536X.2009.00313.x", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19489809", "accessDate": "2010-04-09T07:29:45Z", "PMID": "", "PMCID": "", "ISSN": "1523-536X", "archive": "", "archiveLocation": "", "shortTitle": "An emerging \"maternal near-miss syndrome\"", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19489809", "tags": [ { "tag": "Adolescent", "type": 1 }, { "tag": "Adult", "type": 1 }, { "tag": "Brazil", "type": 1 }, { "tag": "Fear", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Hospitals, University", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Intensive Care Units", "type": 1 }, { "tag": "Life Change Events", "type": 1 }, { "tag": "Maternal Welfare", "type": 1 }, { "tag": "Morbidity", "type": 1 }, { "tag": "Narration", "type": 1 }, { "tag": "Obstetric Labor Complications", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Pregnancy Complications", "type": 1 }, { "tag": "Puerperal Disorders", "type": 1 }, { "tag": "Qualitative Research", "type": 1 }, { "tag": "Socioeconomic Factors", "type": 1 }, { "tag": "Syndrome", "type": 1 }, { "tag": "Young Adult", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-04-09T09:11:33Z", "dateModified": "2010-04-09T09:11:33Z" } } ]