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Priorities in emerg...
Priorities in emergency obstetric care in Bolivia : maternal mortality and near-miss morbidity in metropolitan La Paz
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- Rööst, Mattias (författare)
- Uppsala universitet,Institutionen för kvinnors och barns hälsa,Internationell kvinno- & mödrahälsovård/Essén
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- Altamirano, V. C. (författare)
- La Paz Hospital, La Paz, Bolivia
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- Liljestrand, Jerker (författare)
- Lund University,Lunds universitet,Socialmedicin och global hälsa,Forskargrupper vid Lunds universitet,Social Medicine and Global Health,Lund University Research Groups,Division of Social Medicine and Global Health, Lund University, Malmö, Sweden
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- Essén, Birgitta (författare)
- Uppsala universitet,Institutionen för kvinnors och barns hälsa,Internationell kvinno- & mödrahälsovård/ Essén
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(creator_code:org_t)
- 2009-05-14
- 2009
- Engelska.
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Ingår i: BJOG : An International Journal of Obstetrics and Gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 116:9, s. 1210-1217
- Relaterad länk:
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- OBJECTIVE: To document the frequency and causes of maternal mortality and severe (near-miss) morbidity in metropolitan La Paz, Bolivia. DESIGN: Facility-based cross-sectional study. SETTING: Four maternity hospitals in La Paz and El Alto, Bolivia, where free maternal health care is provided through a government-subsidised programme. POPULATION: All maternal deaths and women with near-miss morbidity. METHODS: Inclusion of near-miss using clinical and management-based criteria. MAIN OUTCOME MEASURES: Maternal mortality ratio (MMR), severe morbidity ratio (SMR), mortality indices and proportion of near-miss cases at hospital admission. RESULTS: MMR was 187/100,000 live births and SMR was 50/1000 live births, with a relatively low mortality index of 3.6%. Severe haemorrhage and severe hypertensive disorders were the main causes of near-miss, with 26% of severe haemorrhages occurring in early pregnancy. Sepsis was the most common cause of death. The majority of near-miss cases (74%) were in critical condition at hospital admission and differed from those fulfilling the criteria after admission as to diagnostic categories and socio-demographic variables. CONCLUSIONS: Pre-hospital barriers remain to be of great importance in a setting of this type, where there is wide availability of free maternal health care. Such barriers, together with haemorrhage in early pregnancy, pre-eclampsia detection and referral patterns, should be priority areas for future research and interventions to improve maternal health. Near-miss upon arrival and near-miss after arrival at hospital should be analysed separately as that provides additional information about factors that contribute to maternal ill-health.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Nyckelord
- Bolivia
- maternal mortality
- near-miss
- severe maternal morbidity
- MEDICINE
- MEDICIN
- severe maternal morbidity
- near-miss
- Bolivia
- maternal mortality
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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