Lost opportunities for effective management of obstetric conditions to reduce maternal mortality and severe maternal morbidity in Argentina and Uruguay

Objective: To review the use of evidence-based practices in the care of mothers who died or had severe morbidity attending public hospitals in two Latin American countries. Methods: This study is part of a multicenter intervention to increase the use of evidence-based obstetric practice. Data on mat...

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Detalles Bibliográficos
Autores: Karolinski, Ariel Pedro, Mazzoni, Agustina, Belizan, Jose, Althabe, Fernando, Bergel, Eduardo, Buekens, Pierre
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2010
País:Argentina
Institución:Consejo Nacional de Investigaciones Científicas y Técnicas
Repositorio:CONICET Digital (CONICET)
Idioma:inglés
OAI Identifier:oai:ri.conicet.gov.ar:11336/189763
Acceso en línea:http://hdl.handle.net/11336/189763
Access Level:acceso abierto
Palabra clave:AUDIT OF CLINICAL PRACTICE
EVIDENCE-BASED MEDICINE
MATERNAL MORTALITY
OBSTETRIC EMERGENCIES
PHYSICIAN'S PRACTICE PATTERNS
PROCESS EVALUATION (HEALTH CARE)
QUALITY OF HEALTH CARE
UTILIZATION REVIEW
https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
Descripción
Sumario:Objective: To review the use of evidence-based practices in the care of mothers who died or had severe morbidity attending public hospitals in two Latin American countries. Methods: This study is part of a multicenter intervention to increase the use of evidence-based obstetric practice. Data on maternal deaths and women admitted to intensive care units whose deliveries occurred in 24 hospitals in Argentina and Uruguay were analyzed. Primary outcomes were use rates of effective interventions to reduce maternal mortality (MM) and severe maternal morbidity (SMM). Results: A total of 106 women were included: 26 maternal deaths and 80 women with SMM. Some effective interventions for severe acute hemorrhage had a high use rate, such as blood transfusion (91%) and timely cesarean delivery (75%), while active management of the third stage of labor (25%) showed a lower rate. The overall use rate of effective interventions was 58% (95% CI, 49%-67%). This implies that 42% of the women did not receive one of the effective interventions to reduce MM and SMM. Conclusion: This study shows a low use of effective interventions to reduce MM and SMM in public hospitals in Argentina and Uruguay. Dissemination and implementation of evidence-based practices must be guaranteed to effectively achieve progress on maternal health.