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Caracterización de la morbilidad materna extremadamente grave en la provincia de Camagüey, 2009 Characterization of extremely severe maternal morbidity in the province of Camagüey, 2009  [cached]
Denia Casta?eda Barberán,Geidy Martín Díaz,Arnaldo Estévez Reinó,Mireya álvarez Toste
Revista Cubana de Higiene y Epidemiología , 2013,
Abstract: Introducción: a través del control y análisis de la morbilidad materna extremadamente grave se tiene una forma acertada y precisa para evaluar el nivel de salud, pues se considera un indicador muy asociado a la muerte materna y una alternativa válida para utilizarla como indicador de la calidad de los cuidados maternos. Objetivo: caracterizar la morbilidad materna extremadamente grave en Camagüey. Métodos: se realizó un estudio descriptivo transversal, desde enero hasta diciembre del a o 2009, con un universo de 72 pacientes que fueron diagnosticadas como morbilidad materna extremadamente grave en los hospitales maternos de Camagüey y la Unidad de Cuidados Intensivos del Hospital Provincial, según criterios de clasificación. La información se obtuvo mediante la historia clínica de cada gestante durante su atención prenatal y hospitalaria. Resultados: el grupo etario que prevaleció fue el de mayor de 35 a os. Se identificaron como riesgo la malnutrición, la hipertensión arterial, la anemia y la infección vaginal. Conclusiones: el diagnóstico de esta entidad se realizó fundamentalmente durante el parto, y la hemorragia obstétrica es la principal causa de morbilidad. Introduction: extremely severe maternal morbidity is closely associated with maternal death and a valid alternative as an indicator of the quality of maternal health care. Therefore, its control and analysis constitute an accurate, precise method to evaluate health status. Objective: characterize extremely severe maternal morbidity in Camagüey. Methods: a descriptive cross-sectional study was conducted from January to December 2009 of 72 patients diagnosed with extremely severe maternal morbidity at Camagüey maternal hospitals and the Intensive Care Unit at the Provincial Hospital, following classification criteria. Data about the pregnant women's prenatal and hospital care were obtained from their medical records. Results: the over-35 age group prevailed. The risk factors identified were malnutrition, arterial hypertension, anemia and vaginal infection. Conclusions: the condition was mostly diagnosed during delivery, obstetric hemorrhage being the main cause of morbidity.
Caracterización de la morbilidad materna extremadamente grave Characterization of critically severe mother morbidity  [cached]
Mireya álvarez Toste,Sergio Salvador álvarez,Guillermo González Rodríguez,Disnardo Raúl Pérez
Revista Cubana de Higiene y Epidemiología , 2010,
Abstract: INTRODUCCIóN: En la actualidad existe un interés creciente por realizar el análisis de la morbilidad materna extremadamente grave, pues resulta ser un indicador muy asociado con la muerte materna y una alternativa válida para utilizarse como medida de evaluación de los cuidados maternos. OBJETIVO: Caracterizar la morbilidad materna extremadamente grave en la Ciudad de La Habana, desde enero hasta junio del a o 2009. MéTODOS: Se realizó un estudio transversal cuyo universo de estudio lo constituyeron todas las gestantes que se diagnosticaron como morbilidad materna extremadamente grave en los hospitales maternos y servicios ginecoobstétricos de hospitales generales y clinicoquirúrgicos, según criterios de inclusión. La información se obtuvo mediante la historia clínica de cada gestante durante su atención prenatal y hospitalaria. RESULTADOS: Se diagnosticaron 46 gestantes, con una edad promedio de 28 a os. Se identificaron riesgos maternos en el 89,1 % de las gestantes. Los riesgos de mayor frecuencia fueron la hipertensión arterial, el asma, la diabetes mellitus y la sepsis urinaria. CONCLUSIONES: La morbilidad materna extremadamente grave ocurrió con mayor frecuencia después del parto. Según los criterios de inclusión, las causas de mayor ocurrencia fueron las relacionadas con el manejo instaurado al paciente (cirugía, UCI, transfusión) y la enfermedad específica (shock séptico e hipovolémico). INTRODUCTION: At the present time there is an increasing interest in carrying out of critically severe mother morbidity analysis because it is an indicator closely associated with the mother death and a valid alternative to use as assessment measure of maternal cares. OBJECTIVE: To characterize the critically severe mother morbidity in Ciudad de La Habana from January to June, 2009. METHODS: A cross-sectional study was conducted in all pregnant diagnosed with critically severe mother morbidity in maternal hospitals and in the Gynecology and Obstetrics services of general and clinical and surgical hospitals, according to inclusion criteria. Information was obtained from the medical record of each pregnant over its prenatal and hospital care. RESULTS: Diagnosis was made in 46 pregnant with a mean age of 28 years. In 89.1% mother risks were identified where the more frequent ones were high blood pressure, asthma, diabetes mellitus and urinary sepsis. CONCLUSIONS: Critically severe mother morbidity was more frequent after labor. According the inclusion criteria the more prevalent causes were those related to the management of the patient (surgery, ICU, transfusion)
Caracterización del proceso hospitalario de atención a la morbilidad materna extremadamente grave Characterization of the care hospital process of extremely severe maternal morbidity  [cached]
Dianellys Pérez Jiménez,Beatriz Corona Miranda,René Espinosa Díaz,Mireya álvarez Toste
Revista Cubana de Obstetricia y Ginecolog?-a , 2013,
Abstract: Introducción: el término morbilidad materna extremadamente grave o severa, se considera de gran utilidad al ser este un indicador muy asociado a la muerte materna y un estadio intermedio en prácticamente la totalidad de las fallecidas. Objetivo: caracterizar los procesos de atención hospitalaria a la morbilidad materna extremadamente grave en La Habana en el a o 2009. Métodos: se realizó una investigación descriptiva en 6 servicios ginecobstétricos de hospitales generales y maternos de La Habana, en el período comprendido de enero-diciembre del 2009, con el objetivo de caracterizar los procesos de atención hospitalario a las maternas extremadamente graves. Para ello se consultaron las historias clínicas y se completó un formulario creado al efecto, cuyos resultados se vaciaron en una base de datos en Access. Los resultados se expresan a través de promedios y porcentajes y se muestran en tablas y gráficos. Resultados: la clasificación por código de colores y la identificación del riesgo obstétrico mostraron valores de 80,6 % y 73,1 % respectivamente. El seguimiento de los signos precoces de shock hipovolémico solo alcanzó un 81 % y el 77 % de estas pacientes fueron sometidas a la realización de una cesárea de las que el 75,5 % tuvieron una complicación durante o después de este proceder. La morbilidad materna extremadamente grave por enfermedad específica con mayor frecuencia, fue por el shock hipovolémico. Conclusiones: el no cumplimiento de los procesos de atención pudiese influir negativamente en la atención a la morbilidad materna extremadamente grave e inclusive incrementar la mortalidad materna. Introduction: the term extremely serious or severe maternal morbidity is considered very useful as this is an indicator highly associated to maternal death and an intermediate stage in virtually all of the deceased cases. Objective: To characterize the processes of hospital care to extremely severe maternal morbidity in Havana during 2009. Methods: a descriptive study was conducted in six gynecological and maternal services in Havana from January to December 2009, in order to characterize the hospital processes of care to extremely serious maternal cases. Medical records and forms were completed for this purpose. The arising results were taken in a database in Access. Results are expressed through averages and percentages and are shown in tables and graphs. Results: classification by color coding and identification of risk obstetrics showed values of 80.6% and 73.1% respectively. Tracking early signs of hypovolemic shock only reached 81% and 77% of these pa
Morbilidad materna extremadamente grave, un problema actual Extremely severe mother morbidity, a current problem
Mireya álvarez Toste,María del Carmen Hinojosa álvarez,Sergio Salvador álvarez,Reinaldo López Barroso
Revista Cubana de Higiene y Epidemiología , 2011,
Abstract: La morbilidad materna extremadamente grave es la complicación que ocurre durante el embarazo, el parto y el puerperio, que pone en riesgo la vida de la mujer y requiere de una atención inmediata con el fin de evitar la muerte. Como parte de la primera etapa de un proyecto de investigación relacionado con la morbilidad materna extremadamente grave se realizó la actualización sobre este tema, para lo cual se efectuó una revisión bibliográfica. Fueron consultadas las bases de datos LILACS, EBSCO e HINARI, con el uso de los siguientes descriptores: bienestar materno, mortalidad materna y morbilidad. También se utilizo el lenguaje libre con palabras clave aportadas por los autores, tales como: calidad de los cuidados maternos, morbilidad materna y morbilidad materna extremadamente grave. Se utilizaron los operadores booleanos correspondientes y las referencias bibliográficas, acotadas según la norma Vancouver 2010. Los resultados de la búsqueda se limitaron a los últimos cinco a os y a los idiomas inglés, espa ol y portugués. El análisis de la morbilidad materna extremadamente grave emerge como complemento o alternativa a la investigación de las muertes maternas y se considera actualmente el indicador de calidad de los cuidados maternos. La incorporación de este indicador a los reportes epidemiológicos y a los servicios obstétricos aportará nuevos conocimientos sobre una base científica del problema y permitirá de forma oportuna la toma de decisiones para la atención materna en el futuro. The extremely severe mother morbidity is a complication occurring during pregnancy, delivery and the puerperium risking the woman's life and that require of an immediate care to avoid death. As part of the first stage of a research project related to extremely severe mother morbidity an updating on this subject was carried out and a bibliography review. The databases LILACS, EBSCO AND HINARI database were consulted with the use of following descriptors: mother wellbeing, morbidity and mortality as well as a free language using words provided by authors including: quality of mother cares, mother morbidity and extremely severe mother morbidity. The corresponding operators were used and the references selected according to the Vancouver standards, 2010. Results from search were limited to the last 5 years and to English, Spanish and Portuguese languages. The analysis of extremely severe mother morbidity emerges as a complement or alternative to research of mother deaths and nowadays is considered an indicator of mother cares. The addition of this indicator to epidemiologic rep
Caracterización de la morbilidad materna extremadamente grave
álvarez Toste,Mireya; Salvador álvarez,Sergio; González Rodríguez,Guillermo; Pérez,Disnardo Raúl;
Revista Cubana de Higiene y Epidemiolog?-a , 2010,
Abstract: introduction: at the present time there is an increasing interest in carrying out of critically severe mother morbidity analysis because it is an indicator closely associated with the mother death and a valid alternative to use as assessment measure of maternal cares. objective: to characterize the critically severe mother morbidity in ciudad de la habana from january to june, 2009. methods: a cross-sectional study was conducted in all pregnant diagnosed with critically severe mother morbidity in maternal hospitals and in the gynecology and obstetrics services of general and clinical and surgical hospitals, according to inclusion criteria. information was obtained from the medical record of each pregnant over its prenatal and hospital care. results: diagnosis was made in 46 pregnant with a mean age of 28 years. in 89.1% mother risks were identified where the more frequent ones were high blood pressure, asthma, diabetes mellitus and urinary sepsis. conclusions: critically severe mother morbidity was more frequent after labor. according the inclusion criteria the more prevalent causes were those related to the management of the patient (surgery, icu, transfusion) and specific disease, septic and hypovolemic shock.
La histerectomía obstétrica como terapéutica segura en la morbilidad extremadamente grave Obstetric hysterectomy as a safe therapy in the extremely severe morbidity  [cached]
Juan Antonio Suárez González,Mario Gutiérrez Machado,Alexis Corrales Gutiérrez,Vivian Cairo González
Revista Cubana de Obstetricia y Ginecolog?-a , 2011,
Abstract: Introducción: la histerectomía obstétrica se define como la extirpación del útero después de un evento obstétrico, opción terapéutica vinculada con estados de morbilidad obstétrica extremadamente grave. Objetivo: determinar características obstétricas y generales en una población de pacientes con morbilidad obstétrica extremadamente grave a las cuales se les realizó histerectomía obstétrica. Métodos: estudio descriptivo de corte transversal, realizado desde enero del 2007 a diciembre del 2009, en el Hospital Ginecobstétrico "Mariana Grajales" de Santa Clara, Villa Clara. Se revisaron los expedientes de 71 pacientes a quienes se hizo histerectomía obstétrica. Se calculó la incidencia y se identificaron las características clínicas y obstétricas, la relación con el tipo de parto y los principales hallazgos anatomopatológicos asociados a la histerectomía obstétrica. Resultados: se realizó una histerectomía obstétrica cada 463 partos. El promedio de edad de las pacientes fue de 33,8 + 6,78 a os. El 78,6 % tenía antecedentes de cesárea. Predominó la histerectomía total abdominal en el 63,3 % de la muestra y en 27 pacientes se realizaron ligaduras de las arterias hipogástricas, 38 %. Se requirió el ingreso en la terapia intensiva en un 69 % de las pacientes histerectomizadas. No se reportaron muertes maternas vinculadas con las histerectomías obstétricas en estos tres a os en la provincia. Conclusiones: la histerectomía obstétrica es una opción terapéutica asociada a la morbilidad obstétrica extremadamente grave, donde el accionar oportuno, con dominio técnico y cumpliendo las indicaciones pertinentes se convierte en una herramienta que garantiza la vida de muchas pacientes en momentos críticos. Introduction: the obstetric hysterectomy is defined as the removal of uterus after an obstetric event, therapeutic option linked to stages of extremely severe obstetric morbidity. Objective: to determine the obstetric and general features in a group of patients presenting with an extremely severe obstetric morbidity underwent to obstetric hysterectomy. Methods: a cross-sectional and descriptive study was conducted from January, 2007 to December, 2009 in the "Mariana Grajales"Gynecology and Obstetrics Hospital of Santa Clara, Villa Clara province. The medical records of l71 patients were reviewed who underwent obstetric hysterectomy. Incidence was estimated identifying the clinical and obstetric features, the relation with the type of labor and the main anatomical-pathological findings associated with obstetric hysterectomy. Results: an obstetric hysterectomy was perfo
La histerectomía obstétrica como terapéutica segura en la morbilidad extremadamente grave
Suárez González,Juan Antonio; Gutiérrez Machado,Mario; Corrales Gutiérrez,Alexis; Cairo González,Vivian; Pérez Viera,Susley;
Revista Cubana de Obstetricia y Ginecolog?-a , 2011,
Abstract: introduction: the obstetric hysterectomy is defined as the removal of uterus after an obstetric event, therapeutic option linked to stages of extremely severe obstetric morbidity. objective: to determine the obstetric and general features in a group of patients presenting with an extremely severe obstetric morbidity underwent to obstetric hysterectomy. methods: a cross-sectional and descriptive study was conducted from january, 2007 to december, 2009 in the "mariana grajales"gynecology and obstetrics hospital of santa clara, villa clara province. the medical records of l71 patients were reviewed who underwent obstetric hysterectomy. incidence was estimated identifying the clinical and obstetric features, the relation with the type of labor and the main anatomical-pathological findings associated with obstetric hysterectomy. results: an obstetric hysterectomy was performed by 463 labors. the mean age of patients was of 33.8 ± 6.78 years. the 78.6 % had a history of cesarean section. there was predominance of abdominal total hysterectomy in the 63.3 % of the sample and in 27 patients ligatures of hypogastric arteries were performed (38 %). it was necessary the admission in intensive therapy service of the 69 % of hysterectomy patients during this past year in the province. conclusions: the obstetric hysterectomy is a therapeutic option associated with the extremely severe obstetric morbidity, where a timely action, a technical mastery and fulfilling the pertinent indications, it become a tool to guarantee the life of many patients in critical situations.
Algunos factores asociados a la morbilidad obstétrica extremadamente grave Some features associated with the critically severe obstetric mortality
Juan Antonio Suárez González,Mario Gutiérrez Machado,Alexis Corrales Gutiérrez,María Elena Benavides Casal
Revista Cubana de Obstetricia y Ginecolog?-a , 2010,
Abstract: Se realizó un estudio descriptivo longitudinal y prospectivo en el Hospital Universitario Ginecoobstétrico "Mariana Grajales" de Santa Clara de enero de 2007 a diciembre de 2008, con el objetivo de describir los principales factores relacionados con la morbilidad obstétrica grave. Para la recogida de la información se confeccionó un formulario con las variables de interés a través de la revisión de historias clínicas individuales, de entrevistas a las pacientes y de datos ofrecidos por el departamento de estadísticas del hospital. Se constató que en el periodo del estudio 93 pacientes presentaron morbilidad obstétrica grave. Las principales causas estuvieron relacionadas con la hemorragia con 39,8 % y la preeclampsia 37,6%; la sepsis solo apareció relacionada en un 4,3 %; el parto distócico por cesárea fue un evento obstétrico relacionado directamente con la morbilidad grave y la realización de histerectomías obstétricas. Existe una relación directa entre los resultados maternos y los resultados perinatales en este grupo de pacientes. Se utilizaron los servicios de Terapia intensiva en los casos de extrema gravedad y ocurrieron 4 muertes maternas en estos dos a os, se dejaron de vivir un total de 169 a os por causas asociadas a la maternidad, y como promedio de a os de vida potencialmente perdidos, cada mujer dejó de vivir 42,25 a os por dichas causas. A prospective, longitudinal and descriptive study was conducted in "Mariana Grajales" Gynecology-Obstetrics University Hospital from January, 2007 to December, 2008 to describe the major factors related to asevere4 obstetric mortality. For information collection a form was designed including the interesting variables by individual medical records review, by interviews with patients and of data offered by hospital statistic department. We verified that during the study period 93 patients had a severe obstetric mortality. Major causes were related to hemorrhage (39,8%) and pre-eclampsia (37,6%); sepsis only was related to these causes in the 4,3%; dystocia cesarean section labor was a obstetric event related directly to the severe mortality and carrying out of obstetric hysterectomies. There is a direct link among maternal findings and the perinatal ones in this group of patients. Intensive Care Unit services were used in cases critically severe with 4 maternal deaths during these two years with a total of 169 years lost by causes associated with motherhood, and as average of potentially lost life years, each woman lost 42,45 years of life due such causes.
Morbilidad materna extremadamente grave, un problema actual
álvarez Toste,Mireya; Hinojosa álvarez,María del Carmen; álvarez,Sergio Salvador; López Barroso,Reinaldo; González Rodríguez,Guillermo; Carbonell,Isabel; Pérez González,Raúl;
Revista Cubana de Higiene y Epidemiolog?-a , 2011,
Abstract: the extremely severe mother morbidity is a complication occurring during pregnancy, delivery and the puerperium risking the woman's life and that require of an immediate care to avoid death. as part of the first stage of a research project related to extremely severe mother morbidity an updating on this subject was carried out and a bibliography review. the databases lilacs, ebsco and hinari database were consulted with the use of following descriptors: mother wellbeing, morbidity and mortality as well as a free language using words provided by authors including: quality of mother cares, mother morbidity and extremely severe mother morbidity. the corresponding operators were used and the references selected according to the vancouver standards, 2010. results from search were limited to the last 5 years and to english, spanish and portuguese languages. the analysis of extremely severe mother morbidity emerges as a complement or alternative to research of mother deaths and nowadays is considered an indicator of mother cares. the addition of this indicator to epidemiologic reports and to obstetric services will supply new knowledges on the scientific basis of problem and will allow in a timely way the decisions-making for the future mother care.
Algunos factores asociados a la morbilidad obstétrica extremadamente grave
Suárez González,Juan Antonio; Gutiérrez Machado,Mario; Corrales Gutiérrez,Alexis; Benavides Casal,María Elena; Carlos Tempo,Dalberto;
Revista Cubana de Obstetricia y Ginecolog?-a , 2010,
Abstract: a prospective, longitudinal and descriptive study was conducted in "mariana grajales" gynecology-obstetrics university hospital from january, 2007 to december, 2008 to describe the major factors related to asevere4 obstetric mortality. for information collection a form was designed including the interesting variables by individual medical records review, by interviews with patients and of data offered by hospital statistic department. we verified that during the study period 93 patients had a severe obstetric mortality. major causes were related to hemorrhage (39,8%) and pre-eclampsia (37,6%); sepsis only was related to these causes in the 4,3%; dystocia cesarean section labor was a obstetric event related directly to the severe mortality and carrying out of obstetric hysterectomies. there is a direct link among maternal findings and the perinatal ones in this group of patients. intensive care unit services were used in cases critically severe with 4 maternal deaths during these two years with a total of 169 years lost by causes associated with motherhood, and as average of potentially lost life years, each woman lost 42,45 years of life due such causes.
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