Maternal near miss: determinantes de morbilidad materna extrema en pacientes de la unidad de cuidados intensivos del hospital de especialidades Teodoro Maldonado Carbo en los años 2020-2022.
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2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
INTRODUCCIÓN: La Morbilidad Materna Extrema (MME) son aquellas
complicaciones obstétricas severas que ponen en riesgo la vida de la mujer y
que requiere una intervención médica urgente para prevenir la muerte.
MATERIALES Y MÉTODOS: Se realizó un estudio de incidencia, de tipo
observacional, no experimental, según el alcance es una investigación
descriptiva, transversal y retrospectiva, se consideró una población de 3935
pacientes de los cuales posterior al análisis individual de cada expediente clínico
se redujo el total de casos a 179 pacientes que cumplieron con los criterios de
inclusión.
RESULTADOS: Se evidenció que el grupo etario que comprendió entre los 31
– 40 años es el que más casos Near Miss presentó, siendo este grupo el 41%
de los casos, el criterio que predomina en estas pacientes corresponde a el
shock (13.9%), seguido de las convulsiones incontrolables presentadas en la
eclampsia y la insuficiencia respiratoria, ambos representando el 11.4%, las
transfusiones masivas de hemoderivados (≥3unidades) con un 10.2%, como las
más frecuentes. Las principales patologías que ocasionaron los criterios de
Near Miss fueron los trastornos hipertensivos: preeclampsia severa, habiendo
un total de 29 casos (24.8%), y eclampsia con 19 casos (16.2%), seguidas de
hemorragia postparto con 16 casos (13.7%).
CONCLUSIONES: La morbilidad materna extrema (Near Miss) es un
complemento importante dentro de la investigación de mortalidad materna,
debido a que existen más casos Near Miss que de muerte materna.
INTRODUCTION: Maternal Near Miss are those severe obstetric complications that put the life of the woman at risk and that require urgent medical intervention to prevent the death of the mother. MATERIALS AND METHODS: An observational, non-experimental incidence study was carried out, according to the scope it is a descriptive, cross-sectional and retrospective investigation, a population of 3935 patients was considered, of which after the individual analysis of each clinical file the total number of cases was reduced. 179 patients who met the inclusion criteria. RESULTS: We were able to show that the age group comprised between 31 - 40 years is the one that presented the most Near Miss cases, this group being 41% of the cases, the predominant criterion in these patients corresponds to shock (13.9%), followed by uncontrollable seizures presented in eclampsia and respiratory failure, both representing 11.4%, massive transfusions of blood products (≥3 units) with 10.2%, as the most frequent. The main pathologies that caused the Near Miss criteria were hypertensive disorders: severe preeclampsia, with a total of 29 cases (24.8%), and eclampsia with 19 cases (16.2%), followed by postpartum hemorrhage with 16 cases (13.7%). CONCLUSIONS: Maternal Near Miss is an important complement in maternal mortality investigation, because there are more Near Miss cases than maternal death, these allow us to inform and conclude the different obstacles that arose during health care, being a determinant on the quality of maternal care, Near Miss cases are a life lesson that show us our deficiencies that must be overcome.
INTRODUCTION: Maternal Near Miss are those severe obstetric complications that put the life of the woman at risk and that require urgent medical intervention to prevent the death of the mother. MATERIALS AND METHODS: An observational, non-experimental incidence study was carried out, according to the scope it is a descriptive, cross-sectional and retrospective investigation, a population of 3935 patients was considered, of which after the individual analysis of each clinical file the total number of cases was reduced. 179 patients who met the inclusion criteria. RESULTS: We were able to show that the age group comprised between 31 - 40 years is the one that presented the most Near Miss cases, this group being 41% of the cases, the predominant criterion in these patients corresponds to shock (13.9%), followed by uncontrollable seizures presented in eclampsia and respiratory failure, both representing 11.4%, massive transfusions of blood products (≥3 units) with 10.2%, as the most frequent. The main pathologies that caused the Near Miss criteria were hypertensive disorders: severe preeclampsia, with a total of 29 cases (24.8%), and eclampsia with 19 cases (16.2%), followed by postpartum hemorrhage with 16 cases (13.7%). CONCLUSIONS: Maternal Near Miss is an important complement in maternal mortality investigation, because there are more Near Miss cases than maternal death, these allow us to inform and conclude the different obstacles that arose during health care, being a determinant on the quality of maternal care, Near Miss cases are a life lesson that show us our deficiencies that must be overcome.
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COMPLICACIONES OBSTETRICAS, MORBILIDAD MATERNA EXTREMA, MORTALIDAD MATERNA, PREECLAMPSIA, ESTUDIO OBSERVACIONAL, EPIDEMIOLOGIA DESCRIPTIVA, HOSPITAL DE ESPECIALIDADES DR. TEODORO MALDONADO CARBO, CANTON GUAYAQUIL, ECUADOR