Maternal near miss and maternal death in the Pretoria Academic Complex, South Africa : a population-based study

Show simple item record Soma-Pillay, Priya Pattinson, Robert Clive Langa-Mlambo, Lerato Nkosi, B.S.S. Macdonald, A.P. 2015-09-10T11:29:06Z 2015-09-10T11:29:06Z 2015-07
dc.description.abstract BACKGROUND. In order to reduce maternal mortality in South Africa (SA), it is important to understand the process of obstetric care, identify weaknesses within the system, and implement interventions for improving care. OBJECTIVE. To determine the spectrum of maternal morbidity and mortality in the Pretoria Academic Complex (PAC), SA. METHODS. A descriptive population-based study that included all women delivering in the PAC. The World Health Organization definition, criteria and indicators of near miss and maternal death were used to identify women with severe complications in pregnancy. RESULTS. Between 1 August 2013 and 31 July 2014, there were 26 614 deliveries in the PAC. The institutional maternal mortality ratio was 71.4/100 000 live births. The HIV infection rate was 19.9%, and 2.7% of women had unknown HIV status. Of the women, 1 120 (4.2%) developed potentially life-threatening conditions and 136 (0.5%) life-threatening conditions. The mortality index was 14.0% overall, 30.0% for non-pregnancy-related infections, 2.0% for obstetric haemorrhage and 13.6% for hypertension. Of the women with life-threatening conditions, 39.3% were referred from the primary level of care. Vascular, uterine and coagulation dysfunctions were the most frequent organ dysfunctions in women with life-threatening conditions. The perinatal mortality rate was 26.9/1 000 births overall, 23.1/1 000 for women with non-life-threatening conditions, and 198.0/1 000 for women with life-threatening conditions. CONCLUSION. About one in 20 pregnant women in the PAC had a potentially life-threatening condition; 39.3% of women presented to a primary level facility as an acute emergency and had to be transferred for tertiary care. All healthcare professionals involved in maternity care must have knowledge and skills that equip them to manage obstetric emergencies. Review of the basic antenatal care protocol may be necessary. en_ZA
dc.description.librarian am2015 en_ZA
dc.description.uri en_ZA
dc.identifier.citation Soma-Pillay, P, Pattinson, RC, Langa-Mlambo, L, Nkosi, BSS & Macdonald, AP 2015, 'Maternal near miss and maternal death in the Pretoria Academic Complex, South Africa : a population-based study', South African Medical Journal, vol. 105, no. 7, pp. 578-583. en_ZA
dc.identifier.issn 0256-9574 (print)
dc.identifier.issn 2078-5135 (online)
dc.identifier.other 10.7196/SAMJnew.8038
dc.language.iso en en_ZA
dc.publisher Health and Medical Publishing Group en_ZA
dc.rights © 2015 Health & Medical Publishing Group. This work is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0). en_ZA
dc.subject Maternal mortality en_ZA
dc.subject Obstetric care en_ZA
dc.subject Weaknesses en_ZA
dc.subject Improving care en_ZA
dc.subject South Africa (SA) en_ZA
dc.subject Maternal morbidity en_ZA
dc.title Maternal near miss and maternal death in the Pretoria Academic Complex, South Africa : a population-based study en_ZA
dc.type Article en_ZA

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