Severe acute maternal morbidity in rural South Africa


Gandhi, MN; Welz, T; Ronsmans, C; (2004) Severe acute maternal morbidity in rural South Africa. International journal of gynaecology and obstetrics, 87 (2). pp. 180-7. ISSN 0020-7292 DOI: https://doi.org/10.1016/j.ijgo.2004.07.012

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Abstract

: Our objective was to identify the frequency, causes, and avoidable factors of severe acute maternal morbidity (SAMM) in four non-specialist hospitals in rural South Africa.<br/> : We conducted a prospective audit using criteria for SAMM suited to the diagnostic and treatment facilities available in the primary hospital setting. For each case of SAMM, a local audit team assessed the standard of care against local management guidelines and examined avoidable factors. An external specialist also retrospectively examined avoidable factors.<br/> : The facility-based incidence of SAMM was 541 cases per 100,000 births (95% CI 368-767). The commonest organ systems involved were cerebral (42%), coagulation (19%), and vascular dysfunctions (16%). The commonest obstetric diagnoses were eclampsia (39%) and obstetric haemorrhage (32%). Approximately 65% of cases were avoidable.<br/> : A qualitative case review audit of SAMM in a non-specialist rural setting appears feasible and sustainable, and provides valuable information towards improving deficiencies in maternal care.<br/>

Item Type: Article
Keywords: severe acute maternal morbidity, near-miss, obstetrics, audit, pregnancy, complications, maternal health, Africa, Intensive-care, near-miss, mortality, malaria, audit
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
Maternal Health Group
PubMed ID: 15491577
Web of Science ID: 225031800025
URI: http://researchonline.lshtm.ac.uk/id/eprint/14043

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