Abstract

VILLALBA-TOQUICA, Carolina del Pilar  and  MARTINEZ-SILVA, Pablo Andrés. Extreme maternal morbidity at Clínica Universitaria Colombia. Bogotá (Colombia), 2012-2013. Rev Colomb Obstet Ginecol [online]. 2014, vol.65, n.4, pp.290-296. ISSN 0034-7434.  https://doi.org/10.18597/rcog.32.

Objective: To describe extreme maternal morbidity (EMM) in a high-complexity obstetrical clinic. Materials and methods: Descriptive epidemiological surveillance study based on the analysis of the results of the implementation of the EMM surveillance subsystem between June 2012 and June 2013 at Clínica Universitaria Colombia, a referral centre serving patients covered by a private health insurance company in Bogotá (Colombia). The number of pregnant women presenting with extreme maternal morbidity during that time period was determined. Maternal age, the health condition leading to the report, the EMM criteria and the EMM quality indicators were evaluated. A descriptive analysis of the data was performed. The prevalence ratio of extreme maternal morbidity is presented. Results: The prevalence of extreme maternal mortality at the institution was found to be 11 for every 1,000 live births. Of the total number of events, 55% were related to pregnancy bleeds, followed by gestational hypertensive disorders (30%), complications of cardiac comorbidities (9%), and septic shock (6%). Of the 58% of patients who developed organ dysfunction, 52% required admission to the Intensive Care Unit; blood product transfusion was required in 61%, and additional surgery was required in 36%. The mortality ratio was 8%. The EMM/MM ratio was 11:1. The percentage of EMM cases with more than three criteria was 73%. Conclusion: Extreme maternal morbidit y is a frequent problem in this referral centre. Measurement is possible on the basis of passive and active surveillance of defining criteria. Additional information about these quality indicators at a national level is required for inter-institutional comparison.

Keywords : Pregnancy; maternal mortality; maternal morbidity.

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