Publication: Análisis de la mortalidad y morbilidad materna según criterios de la organización mundial de la salud y del Euro-Peristat en el período 2011-2015 en el Hospital General Universitario Gregorio Marañón
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2018-04-09
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Universidad Complutense de Madrid
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Abstract
El riesgo de Pérdida del Bienestar Materno Perinatal (RPBMP) supone la aparición de cualquier entidad de muerte o morbilidad en el binomio materno-fetal, que se relacionan entre sí. En esta Memoria, para la definición y el análisis de la muerte y morbilidad materna se han seguido los criterios planteados por la OMS, el Near Miss y el Euro- Peristat. Mediante un análisis retrospectivo de los partos atendidos en la Maternidad del Hospital General Universitario Gregorio Marañón durante 2011-2015, de las variables clínicas maternas pregestacionales, gestacionales, durante el parto y el postparto así como las neonatales, se establecen la correlación de dichas variables con el riesgo de padecer cada uno de los eventos mórbidos maternos descritos con anterioridad. Dicho análisis se realiza mediante un regresión logística univariada y multivariada, esta última para ajustar la magnitud de efecto de cada variable y la de averiguar un modelo óptimo que minimice el número de variables alcanzando el mayor índice de predicción. Entre los resultados encontrados en un total de 24.059 madres y 24.874 recién nacidos queremos destacar una tasa de muerte fetal de 3-4 por mil partos y dos muertes maternas durante el periodo (8,08 por cien mil recién nacidos vivos). En cuanto al perfil de pacientes relacionados con eventos mórbidos concretamente los trastornos hemorrágicos fueron más frecuentes en multíparas, con patología gestacional que han requerido ingreso, antes de la semana 37 de embarazo, cuyo parto fue asistido durante el turno no programado (guardia) que ha requerido anestesia general, con alteraciones durante el alumbramiento y en recién nacidos con anomalías del crecimiento intrauterino...
The risk of loss of maternal perinatal well-being (RPBMP) implies the appearance of any entity of death or morbidity in the maternal-fetal binomial, which are related to each other. In this Report, the criteria set out by WHO, Near Miss and Euro-Peristat, have been followed for the definition and analysis of death and morbidity. A retrospective analysis of the deliveries attended at the Maternity Hospital of the General University Hospital during 2011-2015, of the clinical variables (maternal pregestational, gestational, during delivery and postpartum as well as neonatal), and the correlation of variables is established. Risk of suffering each of the material morbid events previously. This analysis is performed using a univariate and multivariate logistic regression, the latter to adjust the magnitude of effect of all variables and that of a model that minimizes the number of variables that reached the highest prediction index. Among the results found in a total of 24,059 mothers and 24,874 newborns we want to highlight a fetal death rate of 3-4 per thousand births and two maternal deaths during the period (8.08 per one hundred thousand live births). The profile of patients related to morbid events, specifically the hemorrhagic disorders were more frequent multiparous, with gestational pathology that have required admission, before the 37th week of pregnancy whose delivery was attended during the unscheduled (guard) shift that required general anesthesia, with alterations during childbirth and newborns with intrauterine growth abnormalities...
The risk of loss of maternal perinatal well-being (RPBMP) implies the appearance of any entity of death or morbidity in the maternal-fetal binomial, which are related to each other. In this Report, the criteria set out by WHO, Near Miss and Euro-Peristat, have been followed for the definition and analysis of death and morbidity. A retrospective analysis of the deliveries attended at the Maternity Hospital of the General University Hospital during 2011-2015, of the clinical variables (maternal pregestational, gestational, during delivery and postpartum as well as neonatal), and the correlation of variables is established. Risk of suffering each of the material morbid events previously. This analysis is performed using a univariate and multivariate logistic regression, the latter to adjust the magnitude of effect of all variables and that of a model that minimizes the number of variables that reached the highest prediction index. Among the results found in a total of 24,059 mothers and 24,874 newborns we want to highlight a fetal death rate of 3-4 per thousand births and two maternal deaths during the period (8.08 per one hundred thousand live births). The profile of patients related to morbid events, specifically the hemorrhagic disorders were more frequent multiparous, with gestational pathology that have required admission, before the 37th week of pregnancy whose delivery was attended during the unscheduled (guard) shift that required general anesthesia, with alterations during childbirth and newborns with intrauterine growth abnormalities...
Description
Maternal mortality, Death fetal, Risk of loss of maternal perinatal well-being (RPBMP), Near-Miss criteria, Euro-Peristat criteria