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Mortalidade materna por pré-eclampsia/eclampsia em um estado do Sul do Brasil
Soares, Vania Muniz Néquer;Souza, Kleyde Ventura de;Freygang, Tatiana Claumann;Correa, Vanessa;Saito, Maria Rialto;
Revista Brasileira de Ginecologia e Obstetrícia , 2009, DOI: 10.1590/S0100-72032009001100007
Abstract: purpose: to identify the profile, tendency and causes of maternal death by pre-eclampsia/eclampsia in paraná. methods: descriptive, transversal cohort study on maternal death by pre-eclampsia/eclampsia from 1997 to 2005. data were obtained from case studies prepared by maternal death committees that employ the reproductive age mortality survey method to examine all the cases of death among women in fertile age. the general and specific maternal death rate (mdr) by pre-eclampsia/eclampsia were considered. to evaluate the tendency, triennial periods have been compared, two by two, taking into consideration the mdr of each period (p<0.05). in the triennial period from 2003 to 2005, 56 deaths by pre-eclampsia/eclampsia were analyzed. the variables focused were: age, income, schooling, gestation number and complications, pre-natal conditions, signs and symptoms related to the condition, delivery route, the time gestation was interrupted, the newborn conditions, access and treatment, ability to avoid and prevention measures. results: the general triennial mdr has presented significant decline, with 64.3/100,000 born-alive babies. there has been stability along the period for mdr by hypertensive disorder, with mdr of 11.8/100,000 born-alive. primiparous women, women over 40 and with low socio-economical status have presented higher risks. in relation to the treatment, there has been underuse or inadequate use of conventional medicines for severe pre-eclampsia and eclampsia. the committees' analysis indicated that all the maternal death due to these conditions could have been avoided. conclusions: actions aiming at minimizing the set of causes that lead to death by pre-eclampsia in paraná should be enforced, including the training and monitoring of health professionals in order to apply the treatment protocols, besides the formalization of a reference net of clinics and hospitals, qualified for the care of high risk pregnancy and its intercurrences, to which pre-natal pregn
Morte por AIDS ou morte materna: a classifica o da mortalidade como prática social  [cached]
Bonciani Rosa Dalva F.,Spink Mary Jane P.
Cadernos de Saúde Pública , 2003,
Abstract: O artigo trata da decis o de inclus o ou exclus o de óbitos de mulheres em idade fértil, com HIV/AIDS, nas estatísticas de mortalidade materna. Foram analisados os casos referentes ao ano de 1998, investigados pelo Comitê Central de Mortalidade Materna do Município de S o Paulo (CCMM-MSP). Tendo como enquadre a abordagem construcionista, a pesquisa utilizou como fonte de dados, relatórios e entrevistas com o presidente do CCMM-MSP e membros de um comitê municipal regional. Buscou-se apontar aspectos presentes na sele o, investiga o e classifica o final das mortes maternas investigadas, focalizando os espa os de negocia o entre os vários atores envolvidos no processo. A análise sugere que, quando se trata de óbitos de mulheres com HIV/AIDS, interferem ainda outros fatores como a precedência do status soropositivo para o HIV e os aspectos morais e simbólicos da AIDS. Concluiu-se que o aperfei oamento das estatísticas por meio da melhor compreens o da decis o de inclus o ou exclus o de casos é apenas um lado da quest o; faz-se necessário também, melhorar a qualidade da assistência ao ciclo gravídico-puerperal para evitar a ocorrência dessas mortes.
Anestesia na Pré-Eclampsia  [cached]
Ganem Eliana Marisa,Castiglia Yara Marcondes Machado
Revista Brasileira de Anestesiologia , 2002,
Abstract: JUSTIFICATIVA E OBJETIVOS: Embora a pré-eclampsia acometa pequena porcentagem da popula o obstétrica, ela é responsável por considerável morbidade e mortalidade maternas. Assim sendo, o controle anestésico adequado deste grupo de pacientes ainda hoje é um desafio para os anestesiologistas. Este artigo tem a finalidade de apresentar a fisiopatologia, o tratamento farmacológico e as op es anestésicas para o parto normal ou cirúrgico, em pacientes com pré-eclampsia. CONTEúDO: Est o descritos a classifica o e terminologia da hipertens o arterial induzida pela gesta o, a fisiopatologia, as altera es nos diversos órg os e sistemas, os princípios gerais no controle das pacientes e as op es anestésicas para o parto normal e cirúrgico. CONCLUS ES: O conhecimento, pelo anestesiologista, da fisiopatologia, das formas de tratamento e das características farmacológicas das drogas utilizadas para o controle da hipertens o arterial e a profilaxia das convuls es, assim como sua intera o com as drogas e técnicas anestésicas, possibilita a redu o das complica es peri-operatórias e da mortalidade materna e fetal.
Eclampsia: Repercusión materna y perinatal
Marianela Rivas,Pedro Faneite,Guillermina Salazar
Revista de Obstetricia y Ginecología de Venezuela , 2012,
Abstract: Objetivo: Determinar la incidencia de eclampsia y su repercusión materna y perinatal en el Departamento de Obstetricia y Ginecología. Departamento Clínico Integral de la Costa. Universidad de Carabobo. Hospital “Dr. Adolfo Prince Lara” Puerto Cabello. Métodos: Estudio descriptivo, retrospectivo, longitudinal y analítico de 40 casos con diagnóstico de eclampsia en 31 532 nacimientos en un período de 10 a os: 1998 - 2007. Resultados: La incidencia fue de 0,13 %, 1 caso por cada 788 nacimientos. Predominó el grupo etario de 10 - 19 a os (52,5 %), concubinas 60 %, grado de instrucción primaria (60 %). Prevaleció el antecedente familiar de hipertensión en la madre (25 %), el antecedente personal de preeclampsia en embarazo anterior (12,5 %). Los principales signos y síntomas fueron: hiperreflexia (65 %), cefalea (50 %), escotomas y amaurosis (20 %). La primera convulsión se presentó ante-parto (75 %). Sin control de embarazo (55.%). Destacaron las I gestas (72,5 %), edad de embarazo 37-41 semanas (50 %), tipo de parto: cesárea (85.%). En los resultados perinatales prevaleció: neonatos deprimidos (52,5 %), peso neonatal entre 2.500-3.499 g (50 %), con morbilidad de 30,55 %, la mayoría debido a síndrome de dificultad respiratoria. La mortalidad fetal fue de 9,09 % y la mortalidad neonatal 9,09 %. Morbilidad materna fue de 53,84 %, asociada: síndrome Hellp (23,07 %), insuficiencia renal aguda (7,69 %), desprendimiento prematuro de placenta (7,69 %); hubo una muerte materna (2,5 %). Conclusión: Es importante que todas las mujeres embarazadas reciban atención médica continua y oportuna, lo cual permite el diagnóstico y tratamiento temprano de afecciones como la pre-eclampsia y eclampsia, esta última es una de las mayores emergencias obstétricas; esta revisión revela una vez más que contribuye decididamente a la morbi-mortalidad materna y perinatal. Implica una asistencia precoz e intensiva para disminuir sus repercusiones. Objective: To determine the incidence of eclampsia and maternal and perinatal impact en el Departamento de Obstetricia y Ginecologia, Hospital “Dr. Adolfo Prince Lara”, Departamento Clínico Integral de la Costa, Universidad de Carabobo. Puerto Cabello. Methods: A descriptive, retrospective, longitudinal and analytical diagnosis of 40 cases in 31 532 births eclampsia over a period of 10 years from 1998 to 2007. Results: The incidence was 0.13 %, 1 case per 788 births. The predominant age group of 10 - 19 years (52.5 %), concubines 60 %, primary education level (60 %). The prevailing family history of hypertension in the mother (25 %), personal hi
Mortalidade materna por cardiopatia
Feitosa,Helvécio N.; Moron,Ant?nio F.; Born,Daniel; Almeida,Pedro Augusto Marcondes de;
Revista de Saúde Pública , 1991, DOI: 10.1590/S0034-89101991000600005
Abstract: a retrospective study on maternal mortality in pregnant women with cardiac disease over a period of eleven years (january 1979 to december 1989) was undertaken. the objetive was an analysis of the main aspects of this association. cardiac disease was diagnosed in 694 patients (4.2%) of a total of 16,423 admitted to the obstetrics department of the escola paulista de medicina. as for etiology, rheumatic disease (52.3%); chagas's disease (19.3%) and congenital disease (8.1%) were the most frequent causes. there were 51 maternal deaths, according to figo's definition (1967), corresponding to a maternal mortality rate of 428.2/100,000 livebirths during the same period. twelve of these maternal deaths were due to cardiac disease (maternal mortality rate of 100.8/100,000 livebirths). the statistical analysis identified the following aspects associated with maternal mortality among patients with cardiac disease: primigravida, lack of adequate prenatal care, and cardiac surgery performed previously to and/or during pregnancy. congestive heart failure with pulmonary edema (41.7%) and thromboembolism (25.0%) were the most frequent causes of maternal death among patients with cardiac disease. the nyha functional classification was not a good parameter for pregnancy prognosis: eleven patients (91.7%) were considered as belonging to the favorable group before they became pregnant. most maternal deaths occurred during the first 72 hours after delivery. therefore, this period was considered most critical for maternal mortality in patients with cardiac disease. no relation-ship was found among the factors: maternal age, race, marital status, delivery and maternal mortality among patients with cardiac disease. the effects of maternal death on the prognosis of the fetus and newborn were severe: 1/3 were undelivered; 1/2 premature liveborn, one fetus died during delivery and an other in the neonatal period. thus a loss of 50.0% of the conceptuses occurred in this group.
Mortalidade materna na cidade do Recife
Costa Aurélio Ant?nio Ribeiro,Ribas Maria do Socorro Sampaio de Sousa,Amorim Melania Maria Ramos de,Santos Luiz Carlos
Revista Brasileira de Ginecologia e Obstetrícia , 2002,
Abstract: Objetivos: determinar a Raz o de Mortalidade Materna (RMM) entre mulheres residentes na cidade do Recife, pela análise de todas as declara es de óbito de mulheres na idade entre 10-49 anos. Determinar a taxa de sub-registro e estudar as principais características, causas básicas, classifica o e evitabilidade das mortes maternas. Métodos: realizou-se estudo descritivo de base populacional, analisando-se todos as declara es de óbito de mulheres entre 10-40 anos e utilizando-se os critérios de Laurenti para classificá-los como declarados ou presumíveis. Estudaram-se os prontuários médicos e os dados de autópsia, quando disponíveis, determinando-se as causas básicas dos óbitos e calculando-se a taxa de sub-registro. A Raz o de Mortalidade Materna foi calculada usando as informa es sobre nascidos vivos do SINASC (Sistema de Informa es dos Nascidos Vivos). Resultados: encontraram-se 144 mortes maternas, sendo 104 declaradas e 44 presumíveis, confirmadas após investiga o. A Raz o de Mortalidade Materna foi 75,5 por 100.000 nascidos vivos e o percentual de sub-registro foi 27,8%. Observou-se uma predominancia de causas diretas, sendo as mais freqüentes hipertens o (19%), hemorragia (16%) e infec o (11%). Cerca de 82% das mortes foram consideradas evitáveis por meio de assistência adequada ao pré-natal, parto e puerpério. Conclus es: a Raz o de Mortalidade Materna é alta na cidade de Recife, e o percentual de subnotifica o permanece elevado. Predominam as causas diretas e os óbitos evitáveis, evidenciando ausência de assistência adequada ao pré-natal, parto e puerpério.
Reflex es sobre a mensura o da mortalidade materna  [cached]
Laurenti Ruy,Mello-Jorge M. Helena P. de,Gotlieb Sabina Léa Davidson
Cadernos de Saúde Pública , 2000,
Abstract: A mortalidade materna é um ótimo indicador da saúde da mulher e, de certa forma, da saúde geral da popula o. Há grande disparidade entre as taxas (ou raz es) referentes a diferentes áreas, sendo seu valor bastante elevado nos países subdesenvolvidos ou em desenvolvimento, como é o caso do Brasil. Numerosos países adotaram programas visando a redu o da mortalidade materna, necessitando, ent o, conhecer as respectivas taxas (ou raz es) para avaliar e monitorar esses programas. Ocorrem, por várias motivos, dificuldades em conhecer a verdadeira magnitude dessas mensura es. O trabalho apresenta métodos propostos para estimar a mortalidade materna, destacando-se a necessidade de ver com certa reserva os métodos indiretos, preferindo-se sempre, como no caso do Brasil, o aperfei oamento do registro civil, fonte legítima dos dados de nascimentos e de mortes.
Mortalidade materna por hipertens?o: índice e análise de suas características em uma maternidade-escola
Bezerra, Elmiro Hélio Martins;Alencar Júnior, Carlos Augusto;Feitosa, Regina Fátima Gon?alves;Carvalho, Arnaldo Afonso Alves de;
Revista Brasileira de Ginecologia e Obstetrícia , 2005, DOI: 10.1590/S0100-72032005000900008
Abstract: purpose: to study maternal mortality caused by hypertension during pregnancy, determining the mortality rate and the profile of those patients. methods: a retrospective study of maternal mortality caused by hypertension at the maternidade escola assis chateaubriand of the universidade federal do ceará, from 1981 to 2003. general maternal mortality rate (mmr) and specific maternal mortality rate due to hypertension were evaluated, as well as these patients' epidemiological and clinical data. results: two hundred and ninety six cases of maternal death and 184,672 of live births were recorded, with a mmr of 160.28/100.000 live births. the most frequent cause of death was hypertension (41.2%); with 122 cases and an annual average of 5.3 deaths, and hypertension mmr of 60.10/100,000 live births. the women's age range varied from 13 to 42 years with an average of 26 years. most of the patients came from the interior of the state. deaths occurred predominantly in the first 24 hours after admission to the hospital (50.9%). deaths were predominant in the first pregnancy (40.3%) and in women with 31 to 38 weeks gestational age (48.2%). eclampsia occurred in 73 patients (64.1%) and was predominant along the gestational period (53.4%). there were 101 deaths in the puerperium. cesarean section (62.3%) and general anesthesia (45.1%) prevailed. a high percentage of patients (61.4%) had no prenatal care. conclusions: general mmr and hypertension mmr were high, the latter being the main cause of death in our maternity hospital.
Eclampsia: Morbilidad y mortalidad materna y perinatal
Gabriela Valarino,Adriana Mora,Carlos Cabrera,Isbelly Durán
Revista de Obstetricia y Ginecología de Venezuela , 2009,
Abstract: Objetivo: Evaluar el impacto de la eclampsia sobre la morbilidad y mortalidad materno fetal. Métodos: Estudio retrospectivo, descriptivo y longitudinal, incluyó 102 pacientes con diagnóstico de trastorno hipertensivo del embarazo tipo eclampsia durante 2006-2007. Se utilizó una hoja de registro que contenía las variables del presente estudio. Ambiente: Unidad de Medicina Materno Fetal, Maternidad "Concepción Palacios", Caracas. Resultados: En este período se atendió un total de 28 617 partos, de los cuales 102 (0,35 %) presentaron eclampsia. Los principales síntomas fueron cefalea (57,84 %) e hipertensión (85,29 %), la convulsión se presentó anteparto en el 63,72 %, la principal complicación fue síndrome HELLP en 38,23 %. Un 80,48.% de los neonatos nacieron vivos y la mortalidad perinatal fue de 18,75 %. Conclusión: La eclampsia es una causa importante de morbi-mortalidad materna y perinatal. Objective: To evaluate the impact of eclampsia on maternal and fetal morbidity and mortality. Methods: Retrospective, descriptive and longitudinal study, that included 102 patients with diagnostic hypertensive distress of pregnancy eclampsia’s type during 2006-2007. A record sheet containing the variables of the study was used. Setting: Unidad de Medicina Materno Fetal, Maternidad "Concepcion Palacios", Caracas. Results: During the study period 28 617 deliveries were attended, from which 102 (0.35 %) presented eclampsia. The main symtoms were headache (57.84 %) and hypertension (85.29 %), seizure appreas before delivery in 63.72 %, the main complication was HELLP syndrome in 38.23 %. The 80-48 % of the neonates were born alive and perinatal mortality was 18.75 %. Conclusion: Eclampsia is an important cause of maternal and perinatal morbi-mortaliy.
Mortalidade materna no Brasil, 1980
Siqueira,Arnaldo Augusto Franco de; Tanaka,Ana Cristina d'Andretta; Santana,Renato Martins; Almeida,Pedro Augusto Marcondes de;
Revista de Saúde Pública , 1984, DOI: 10.1590/S0034-89101984000600004
Abstract: brazilian maternal mortality is studied on the basis of official statistics from the country's various geographical regions, including especially the state of s. paulo (brazil). 1980 was chosen because of the possibility of working with data from the population census of that year. the principal causes of death in brazil were found to be, in the following order: hypertensive states, haemorrhage, puerperal infections and abortion. in s. paulo, where the fourth digit of the idc is used, the first cause of death was eclampsia. the second was haemorrhage and the third the infections, whether due to or associated with pregnancy. as for age, one observed that the lowest maternal mortality rate occurred in the 20 to 29-year-old age group, the rate for 15-19 being slightly higher and increasing gradually in the age groups 30-39 and 40-49 years of age. it must be stated that it was not possible to analyse the rates for the 10 to 14 and over 50 age groups because of the lack of data on livebirths. however, there were 18 and 4 deaths respectively in those two groups which shows that at the extreme limits of the reproductive age there exists a not inconsiderable loss of life, mainly in the case of girls (adolescents) who are not taken into consideration at the present time in the prevailing health programs. on comparing these data with those of other countries it was found that the majority of deaths are avoidable and that it should be possible to reduce the number considerably by means of better assistance to women, and by the use of the techniques and resources which are already available.
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