Abstract

VELEZ-ALVAREZ, Gladis Adriana; GOMEZ-DAVILA, Joaquín Guillermo  and  ZULETA-TOBON, John Jairo. Analysing maternal deaths caused by haemorrhage in the department of Antioquia, Colombia from 2004 to 2005. Rev Colomb Obstet Ginecol [online]. 2006, vol.57, n.3, pp.147-155. ISSN 0034-7434.

Objective: identifying the factors influencing maternal mortality caused by obstetric haemorrhage in the department of Antioquia (Colombia) during 2004-2005. Methodology: a retrospective descriptive study having quantitative and qualitative components. The cases were analysed using the “Pathway to survival - Maternal mortality” methodology which identifies three delays caused by (1) the community in identifying the disease or consulting a doctor, (2) difficulties regarding access to health services and (3) deficiencies in the quality or prospect of being attended. Results: obstetric haemorrhage was mainly caused by postpartum haemorrhage. 29% of patients who died following vaginal childbirth gave birth at home. All deaths were considered avoidable and the main detected factors occurred within category 1 (43%) and 3 (88%) delays. The main causes in type 3 delay were the poor quality of assessing a patient’s condition, inopportune conduct and substandard patient care, active management of the third state of labour was not applied to all patients, inadequate treatment of hypovolemic shock and blood components were administered too late. Conclusions: obstetrical haemorrhage has the greatest influence on maternal mortality in the department of Antioquia. Attempts at improving the situation must deal with implementing active management of the third state of labour and early diagnosis, aggressive volume replacement and resuscitation.

Keywords : postpartum hemorrhage; obstetric hemorrhage; maternal mortality; hypovolemic shock.

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