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Maternal near-miss ...
Maternal near-miss and death and their association with caesarean section complications : a cross-sectional study at a university hospital and a regional hospital in Tanzania
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- Litorp, Helena, 1980- (författare)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell kvinno- & mödrahälsovård och migration/Essén
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- Kidanto, Hussein L (författare)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell kvinno- & mödrahälsovård och migration/Essén
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- Rööst, Mattias (författare)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell kvinno- & mödrahälsovård och migration/Essén
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- Abeid, Muzdalifat, 1973- (författare)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell sexuell och reproduktiv hälsa/Larsson
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- Nyström, Lennarth (författare)
- Umeå universitet,Epidemiologi och global hälsa,Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Sweden
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- Essén, Birgitta, 1961- (författare)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell kvinno- och mödrahälsovård och migration/Essén
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(creator_code:org_t)
- 2014-07-23
- 2014
- Engelska.
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Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central. - 1471-2393 .- 1471-2393. ; 14:1, s. 244-
- Relaterad länk:
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https://umu.diva-por... (primary) (Raw object)
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visa fler...
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https://bmcpregnancy...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- BACKGROUND: The maternal near-miss (MNM) concept has been developed to assess life-threatening conditions during pregnancy, childhood, and puerperium. In recent years, caesarean section (CS) rates have increased rapidly in many low- and middle-income countries, a trend which might have serious effects on maternal health. Our aim was to describe the occurrence and panorama of maternal near-miss and death in two low-resource settings, and explore their association with CS complications.METHODS: We performed a cross-sectional study, including all women who fulfilled the WHO criteria for MNM or death between February and June 2012 at a university hospital and a regional hospital in Dar es Salaam, Tanzania. Cases were assessed individually to determine their association with CS. Main outcome measures included MNM ratio; maternal mortality ratio; proportion of MNM and death associated with CS complications; and the risk for such outcomes per 1,000 operations. The risk ratio of life-threatening CS complications at the university hospital compared to the regional hospital was calculated.RESULTS: We identified 467 MNM events and 77 maternal deaths. The MNM ratio was 36 per 1,000 live births (95% CI 33-39) and the maternal mortality ratio was 587 per 100,000 live births (95% CI 460-730). Major causes were eclampsia and postpartum haemorrhage, but we also detected nine MNM events and five deaths from iatrogenic complications. CS complications accounted for 7.9% (95% CI 5.6-11) of the MNM events and 13% (95% CI 6.4-23) of the maternal deaths. The risk of experiencing a life-threatening CS complication was three times higher at the regional hospital (22/1,000 operations, 95% CI 12-37) compared to the university hospital (7.0/1,000 operations, 95% CI 3.8-12) (risk ratio 3.2, 95% CI 1.5-6.6).CONCLUSIONS: The occurrence of MNM and death at the two hospitals was high, and many cases were associated with CS complications. The maternal risks of CS in low-resource settings must not be overlooked, and measures should be taken to avoid unnecessary CSs. More comprehensive training of staff, improved postoperative surveillance, and a more even distribution of resources within the health care system might reduce the risks of CS.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Nyckelord
- Maternal near-miss; Maternal death; Caesarean section; Low-income country
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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