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[PMID]:29178578
[Au] Autor:Mnyani CN; Buchmann EJ; Chersich MF; Frank KA; McIntyre JA
[Ad] Endereço:School of Clinical Medicine, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Johannesburg, South Africa.
[Ti] Título:Trends in maternal deaths in HIV-infected women, on a background of changing HIV management guidelines in South Africa: 1997 to 2015.
[So] Source:J Int AIDS Soc;20(3), 2017 Nov.
[Is] ISSN:1758-2652
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: As work begins towards the Sustainable Development Goal target of reducing the global maternal mortality ratio (MMR) to less than 70 deaths per 100,000 live births by 2030, much needs to be done in ending preventable maternal deaths. After 1990, South Africa experienced a reversal of gains in decreasing maternal mortality, with an increase in HIV-related maternal deaths. In this study, we assessed trends in maternal mortality in HIV-infected women, on a background of an evolving HIV care programme. METHODS: This was a cross-sectional, retrospective record review of maternal deaths in the obstetrics unit at Chris Hani Baragwanath Academic Hospital, in Johannesburg, South Africa, a referral hospital in a high HIV prevalence setting where the prevalence among pregnant women has plateaued around 29.0% for the past decade. Trends in HIV diagnosis and management in pregnancy, and causes of maternal deaths in HIV-infected women were analysed over different time periods (1997 to 2003, 2004 to 2009, 2010 to 2012, and 2013 to 2015) reflecting major guideline changes. RESULTS: From January 1997 to December 2015, there were 692 maternal deaths in the obstetrics unit. Of the 490 (70.8%) maternal deaths with a documented HIV status, 335 (68.4%) were HIV-infected. A Chi-squared test for trends showed that the institutional MMR (iMMR) in women known to be HIV-infected peaked in the period 2004 to 2009 at 380 (95% CI 319 to 446) per 100,000 live births, with a decline to 267 (95% CI 198 to 353) in 2013 to 2015, p = 0.049. This decrease coincided with changes in the South African HIV management guidelines, mainly increased availability of antiretroviral therapy (ART). Non-pregnancy related infections were the leading cause of death throughout the review period, accounting for 61.5% (206/335) of deaths. Only 23.3% (78/335) of the women who died were on ART at the time of death, this in the context of advanced immune suppression and an overall median CD4 count of 136 cells/µl (interquartile ranges (IQR) 45 to 301). CONCLUSION: In this 19-year review of maternal deaths in Johannesburg, South Africa, there was evidence of a decrease in the iMMR among HIV-infected women, but it remains unacceptably high. Efforts to address drivers of mortality and barriers to accessing ART need to be accelerated if we are to see substantial decreases in maternal mortality.
[Mh] Termos MeSH primário: Infecções por HIV/mortalidade
Morte Materna
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Feminino
Infecções por HIV/epidemiologia
Infecções por HIV/terapia
Seres Humanos
Gravidez
Prevalência
Estudos Retrospectivos
África do Sul/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1002/jia2.25022


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[PMID]:29240754
[Au] Autor:Okonofua F; Imosemi D; Igboin B; Adeyemi A; Chibuko C; Idowu A; Imongan W
[Ad] Endereço:Program and Research Unit, Women's Health and Action Research Centre (WHARC), Benin City, Edo State, Nigeria.
[Ti] Título:Maternal death review and outcomes: An assessment in Lagos State, Nigeria.
[So] Source:PLoS One;12(12):e0188392, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The objective of the study was to investigate the results of Maternal and Perinatal Death Surveillance and Response (MPDSR) conducted in three referral hospitals in Lagos State, Nigeria over a two-year period and to report the outcomes and the lessons learned. MPDRS panels were constituted in the three hospitals, and beginning from January 2015, we conducted monthly MPDSR in the three hospitals using a nationally approved protocol. Data on births and deaths and causes of deaths as identified by the MPDSR panels were collated in the hospitals. The results show that over a 21-month period (January 1, 2015 -September 30, 2016), maternal mortality ratio (MMR) remained high in the hospitals. Although there was a trend towards an increase in MMR in Lagos Island Maternity Hospital and Gbagada General Hospital, and a trend towards a decline in Ajeromi Hospital, none of these trends were statistically significant. Eclampsia, primary post-partum haemorrhage, obstructed labour and puerperal sepsis were the leading obstetric causes of death. By contrast, delay in arrival in hospital, the lack of antenatal care and patients' refusal to receive recommended treatment were the patients' associated causes of death, while delay in treatment, poor use of treatment protocols, lack of equipment and lack of skills by providers to use available equipment were the identified facility-related causes of death. Failure to address the patients and facility-related causes of maternal mortality possibly accounted for the persistently high maternal mortality ratio in the hospitals. We conclude that interventions aimed at redressing all causes of maternal deaths identified in the reviews will likely reduce the maternal mortality ratios in the hospitals.
[Mh] Termos MeSH primário: Morte Materna
[Mh] Termos MeSH secundário: Causas de Morte
Feminino
Seres Humanos
Nigéria/epidemiologia
Vigilância da População
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188392


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[PMID]:29215526
[Au] Autor:St Pierre A; Zaharatos J; Goodman D; Callaghan WM
[Ad] Endereço:CDC Foundation and the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
[Ti] Título:Challenges and Opportunities in Identifying, Reviewing, and Preventing Maternal Deaths.
[So] Source:Obstet Gynecol;131(1):138-142, 2018 Jan.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Despite many efforts at the state, city, and national levels over the past 70 years, a nationwide consensus on how best to identify, review, and prevent maternal deaths remains challenging. We present a brief history of maternal death surveillance in the United States and compare the three systems of national surveillance that exist today: the National Vital Statistics System, the Pregnancy Mortality Surveillance System, and maternal mortality review committees. We discuss strategies to address the perennial challenges of shared terminology and accurate, comparable data among maternal mortality review committees. Finally, we propose that with the opportunity presented by a systematized shared data system that can accurately account for all maternal deaths, state and local-level maternal mortality review committees could become the gold standard for understanding the true burden of maternal mortality at the national level.
[Mh] Termos MeSH primário: Causas de Morte
Morte Materna/prevenção & controle
Complicações na Gravidez/mortalidade
Prevenção Primária/métodos
[Mh] Termos MeSH secundário: Estudos Transversais
Feminino
Seres Humanos
Incidência
Morte Materna/estatística & dados numéricos
Mortalidade Materna/tendências
Avaliação de Resultados (Cuidados de Saúde)
Gravidez
Complicações na Gravidez/diagnóstico
Medição de Risco
Fatores de Risco
Estados Unidos
Estatísticas Vitais
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002417


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[PMID]:28979649
[Au] Autor:Kamga DVT; Nana PN; Fouelifack FY; Fouedjio JH
[Ad] Endereço:Centre Médical de la Garde Présidentielle de Yaoundé, Cameroun.
[Ti] Título:[Role of abortion and ectopic pregnancies in maternal mortality rate at three university hospitals in Yaoundé].
[Ti] Título:Contribution des avortements et des grossesses extra-utérines dans la mortalité maternelle dans trois hôpitaux universitaires de Yaoundé..
[So] Source:Pan Afr Med J;27:248, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:INTRODUCTION: The World Health Organization (WHO) estimates that 585.000 women die every year in the world as a result of complications related to pregnancy, delivery, postpartum period and abortion (the latter contributing to 13% of maternal deaths). Ectopic pregnancies are responsible for 10% of maternal mortality in the first quarter of pregnancy. Maternal mortality rate is high in Cameroon, estimated at 782 per 100.000 live births according to EDS-MICS 2011. AS the role of these two conditions in maternal mortality is little documented in our country, we conducted this study to assess the role of abortions and ectopic pregnancies in maternal mortality rate in Cameroon. METHODS: We conducted a retrospective and analytic study. We collected data from all the medical records of pregnant patients and pregnant patients died before the 28 week of pregnancy at three university hospitals: Central Hospital of Yaoundé (HCY), Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital (HGOPY), University Hospital (CHU), over a period of five years, from 1 June 2011 to 31 May 2016. Data were recorded on a pre-established and tested technical sheet, collected using CS Pro 6.2 software and analyzed using SPSS software 20. The statistical tests for comparison used were Khi 2 and Fischer test according to the effective sample. The threshold significance level was set at p <0.05. RESULTS: We recorded 524 maternal deaths per 31116 live births, reflecting a maternal mortality rate (MMR) of 1538,9/100 000 live births. Out of 524 maternal deaths, 414 medical records were workable, including 100 (24.2%)abortions and 24 (5.8%) ectopic pregnancies. These 2 conditions contributed together to 30% of maternal deaths (124 medical records out of 414). The analysis of 124 medical records showed that the average age was 27.58 +/- 6 years, ranging from 18 to 48 years. The age group 20-24 years was the most represented (33.1%), followed by that 25-29 years (24.19%). The singles constituted 75%, housewives 36.7%, with level of secondary education in 62.5% and multigestes constituted 36.1% of our sample. 73.4% of patients didn't undergo any prenatal consultation and only 2.4% had undergone at least 4 consultations. Complications resulting in deaths were dominated by hemorrhage and infections. CONCLUSION: Abortions and ectopic pregnancies are the major causes of maternal mortality in our country. We recommend strengthening of family planning to limit unwanted pregnancies and socio-economic support for patients at risk.
[Mh] Termos MeSH primário: Aborto Induzido/estatística & dados numéricos
Aborto Espontâneo/epidemiologia
Mortalidade Materna
Gravidez Ectópica/epidemiologia
[Mh] Termos MeSH secundário: Aborto Induzido/efeitos adversos
Adolescente
Adulto
Camarões/epidemiologia
Feminino
Hospitais Universitários
Seres Humanos
Morte Materna/estatística & dados numéricos
Gravidez
Complicações na Gravidez/epidemiologia
Resultado da Gravidez/epidemiologia
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171006
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.248.12942


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[PMID]:28937571
[Au] Autor:Committee on Practice Bulletins-Obstetrics
[Ti] Título:Practice Bulletin No. 183: Postpartum Hemorrhage.
[So] Source:Obstet Gynecol;130(4):e168-e186, 2017 10.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2). In the United States, the rate of postpartum hemorrhage increased 26% between 1994 and 2006 primarily because of increased rates of atony (3). In contrast, maternal mortality from postpartum obstetric hemorrhage has decreased since the late 1980s and accounted for slightly more than 10% of maternal mortalities (approximately 1.7 deaths per 100,000 live births) in 2009 (2, 4). This observed decrease in mortality is associated with increasing rates of transfusion and peripartum hysterectomy (2-4).The purpose of this Practice Bulletin is to discuss the risk factors for postpartum hemorrhage as well as its evaluation, prevention, and management. In addition, this document will encourage obstetrician-gynecologists and other obstetric care providers to play key roles in implementing standardized bundles of care (eg, policies, guidelines, and algorithms) for the management of postpartum hemorrhage.
[Mh] Termos MeSH primário: Obstetrícia/normas
Hemorragia Pós-Parto
Padrão de Cuidado/normas
[Mh] Termos MeSH secundário: Gerenciamento Clínico
Feminino
Seres Humanos
Morte Materna/prevenção & controle
Gravidez
Fatores de Risco
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170923
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002351


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[PMID]:28819529
[Au] Autor:Benkirane S; Saadi H; Mimouni A
[Ad] Endereço:Service de Gynécologie Obstétrique, CHU Mohammed, VI Oujda, Maroc.
[Ti] Título:[Epidemiological profile of maternal complications related to cesarean section at the Al Farabi Hospital in Oujda].
[Ti] Título:Le profil épidémiologique des complications maternelles de la césarienne au CHR EL Farabi Oujda..
[So] Source:Pan Afr Med J;27:108, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:In Morocco cesarean section rate has increased from 2% in 1992 to 16% in 2011. This was associated with increased per- and postoperative mortality and morbidity, which was 19% in our case series. This study is the first of its kind to be conducted in the eastern region of Morocco and aims to analyze the comprehensive epidemiologic profile of maternal complications related to cesarean section on the basis of 2417 cases observed in the Maternity Department at the El Farabi Hospital, Oujda. We conducted an observational, descriptive, retrospective study of a series of 2416 patients undergoing cesarean section in the Maternity Department at the El Farabi Hospital, Oujda, over the period 1 January 2011-31 December 2013. Out of 24464 deliveries, 2416 were cesarean sections, reflecting a rate of 9.87%. The frequency of complications related to cesarean section was 19.45%. Postoperative complications accounted for 63.6% of the complications dominated by infection. Haemorrhagic complications accounted for 25.53% of all complications. 4 cases of maternal deaths were recorded. If the increased rate of cesarean sections has contributed to improve maternal-fetal prognosis, the surgical act itself is not complication-free, which leads us to review its indications for improved patient management.
[Mh] Termos MeSH primário: Cesárea/efeitos adversos
Parto Obstétrico/efeitos adversos
Complicações Pós-Operatórias/epidemiologia
Complicações na Gravidez/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Cesárea/estatística & dados numéricos
Parto Obstétrico/métodos
Feminino
Seres Humanos
Morte Materna
Meia-Idade
Marrocos
Gravidez
Prognóstico
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.108.10036


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[PMID]:28673308
[Au] Autor:Tommila M; Pystynen M; Soukka H; Aydin F; Rantanen M
[Ad] Endereço:Emergency Medical Services, FinnHEMS 20, University of Turku and Turku University Hospital, Savitehtaankatu 1, Turku, Finland. miretta.tommila@tyks.fi.
[Ti] Título:Two cases of low birth weight infant survival by prehospital emergency hysterotomy.
[So] Source:Scand J Trauma Resusc Emerg Med;25(1):62, 2017 Jul 03.
[Is] ISSN:1757-7241
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: During maternal cardiac arrest, emergency hysterotomy (EH) is recommended after four minutes of resuscitation, if no signs of spontaneous circulation are detected. This extreme procedure is believed to be potentially beneficial for both the mother and the infant. Both maternal and neonatal survivals seem to be associated to the time delay between the cardiac arrest and the delivery and in-hospital resuscitation location. In addition to this, gestational age is an important determinant to neonatal outcome. CASE PRESENTATION: We report two emergency hysterotomies executed in an out-of-hospital location. The infants delivered by EH were low birth weight infants and born 20-23 min after maternal cardiac arrest. Both infants survived and had normal physical and neurological growth at the age of two years. Unfortunately, mothers in these both cases died in the field. CONCLUSION: Contrary to earlier beliefs, it is possible to perform a successful EH also in out-of-hospital setting, even with incomplete surgical skills. However, training and preparation are extremely important for achieving the highest possible readiness to treat maternal cardiac arrest situations also prehospitally.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar
Parada Cardíaca/cirurgia
Histerotomia
Recém-Nascido de Baixo Peso
Morte Materna
Complicações Cardiovasculares na Gravidez/cirurgia
[Mh] Termos MeSH secundário: Adulto
Emergências
Serviços Médicos de Emergência
Evolução Fatal
Feminino
Idade Gestacional
Parada Cardíaca/terapia
Seres Humanos
Recém-Nascido
Gravidez
Complicações Cardiovasculares na Gravidez/terapia
Resultado da Gravidez
Sobreviventes
Telemedicina
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170705
[St] Status:MEDLINE
[do] DOI:10.1186/s13049-017-0407-8


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[PMID]:28647961
[Au] Autor:Qin M; Zhu R; Du L; Lu J; Xu HQ; Zhu LP
[Ad] Endereço:Department of Maternal Health, Shanghai Maternal and Child Health Care Center, Shanghai 200062, China.
[Ti] Título:[Analysis of maternal deaths in Shanghai from 1996 to 2015].
[So] Source:Zhonghua Fu Chan Ke Za Zhi;52(6):386-391, 2017 Jun 25.
[Is] ISSN:0529-567X
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To analyze the trend of maternal mortality ratio (MMR) and cause of death in Shanghai from 1996 to 2015. To collect the material about the maternal death and the maternal death audit from 1996 to 2015, and to analyze the MMR, the cause of death and the result of the maternal death audit of Shanghai from 1996 to 2015 retrospectively. (1) The change of MMR: the MMR in Shanghai decreased from 28.84 per 100 000 live births in 1996 to 6.66 per 100 000 live births in 2015. (2) The characteristic of maternal death: the proportion of Shanghai citizens was 27.4%(121/441) and the proportion of migrant women was 72.6%(320/441). The women with advanced maternal age was 8.2% (20/243) since 1996 to 2005, and increased to 16.7% (33/198) since 2006 to 2015. Maternal deaths during pregnancy increased from 27.6%(67/243) in the first 10 years (1996-2005) to 35.4%(70/198) in the recent 10 years (2006-2015) . The intrapartum maternal deaths was 6.2%(15/243) in the first 10 years and in the recent 10 years it was zero. The proportion of postpartum deaths in the first 10 years and in the recent 10 years were 66.3% (161/243) and 64.6%(128/198) respectively. (3) The cause of maternal death: During the recent 10 years, indirect obstetric causes [63.1%(125/198)] was more than direct obstetric causes [36.9% (73/198) ] for the first time. The death causes changed significantly. Postpartum hemorrhage remained the leading cause of maternal deaths, but the specific mortality rate (SMR) of postpartum hemorrhage decreased significantly from 7.42 per 100 000 live births in the first 10 years to 1.51 per 100 000 live births in the recent 10 years. The maternal deaths because of heart disease and cerebrovascular disease rose to the second and the forth reasons. (4) Maternal death audit: the avoidable maternal death ratio decreased from 3.66 per 100 000 live births in the first 10 years to 1.86 per 100 000 live births in the recent 10 years. During the past 20 years, the MMR of Shanghai decreased significantly and was close to the level of developed countries. In recent years, the causes of maternal death become more complicated. With the implementation of the second child policy, women with high risk factors increase, so government investment, policy support should be strengthened to optimize the management.
[Mh] Termos MeSH primário: Morte Materna/estatística & dados numéricos
Mortalidade Materna/tendências
Complicações na Gravidez/mortalidade
[Mh] Termos MeSH secundário: Adulto
Causas de Morte
China
Feminino
Seres Humanos
Nascimento Vivo
Idade Materna
Morte Materna/etnologia
Hemorragia Pós-Parto/mortalidade
Período Pós-Parto
Gravidez
Estudos Retrospectivos
Migrantes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170627
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0529-567X.2017.06.006


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[PMID]:28595070
[Au] Autor:Vuso Z; James S
[Ad] Endereço:Department of Nursing and Midwifery Health Sciences, Nelson Mandela Metropolitan University, North Campus, Port Elizabeth, South Africa. Electronic address: vusovz@gmail.com.
[Ti] Título:Effects of limited midwifery clinical education and practice standardisation of student preparedness.
[So] Source:Nurse Educ Today;55:134-139, 2017 Aug.
[Is] ISSN:1532-2793
[Cp] País de publicação:Scotland
[La] Idioma:eng
[Ab] Resumo:AIM: To explore the perceptions of midwifery educators regarding effects of limited standardisation of midwifery clinical education and practice on clinical preparedness of midwifery students. BACKGROUND: Investigation of levels of clinical competency of students is a critical need in the current era. Such competency levels are especially important in midwifery practice in South Africa as there is a significant increase of maternal deaths and litigations in the country. Most of the deaths are in the primary healthcare level maternity units where the newly qualified midwives practise. These areas are mainly run by midwives only. The current article seeks to report the findings of the study that was conducted to investigate how midwifery educators prepare students adequately for clinical readiness. SETTINGS: The study was conducted amongst midwifery nurse educators on three campuses of the Nursing College in the Eastern Cape. DESIGN: A qualitative, explorative, descriptive and contextual research design was used for the study. DATA SOURCES AND METHODS: Seventeen purposively selected midwifery educators, with the researcher using set criteria, from a Nursing college in the Eastern Cape, were the participants in the study. Data was collected using focus-group interviews that were captured by means of an audio-voice recorder. Tesch's data-analysis method was used to develop themes and sub-themes. Trustworthiness of the study was ensured using the criteria of credibility, transferability, dependability and confirmability. RESULTS: Inconsistent clinical practice amongst midwifery educators in their clinical teaching and assessment were found to be the major factors resulting from limited standardisation. The inconsistent clinical practice and assessments of midwifery educators was found to lead to loss of the necessary skills required by the students which led them to perform poorly in their final clinical assessments. CONCLUSION: There are some barriers in the current clinical teaching and education strategy used in this college that prohibit the production of confident, independent, and safe practitioners as planned. Midwifery educators need to be assisted in reviewing the current teaching strategy. Furthermore management should be involved if not the initiators of that reviewing and should put in-place new measures to support the teaching of the clinical module.
[Mh] Termos MeSH primário: Competência Clínica/normas
Docentes de Enfermagem/psicologia
Tocologia/educação
Tocologia/normas
Estudantes de Enfermagem
[Mh] Termos MeSH secundário: Adulto
Competência Clínica/legislação & jurisprudência
Bacharelado em Enfermagem
Feminino
Grupos Focais
Seres Humanos
Morte Materna/prevenção & controle
Meia-Idade
Pesquisa em Educação de Enfermagem
África do Sul
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE


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[PMID]:28500780
[Au] Autor:Khan T; Laul P; Laul A; Ramzan M
[Ad] Endereço:Department of Obstetrics and Gynaecology, Deen Dayal Upadhyay Hospital, New Delhi, India.
[Ti] Título:Prognostic factors of maternal near miss events and maternal deaths in a tertiary healthcare facility in India.
[So] Source:Int J Gynaecol Obstet;138(2):171-176, 2017 Aug.
[Is] ISSN:1879-3479
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To study maternal near miss (MNM) and maternal mortality to identify rectifiable risk factors. METHODS: The present cross-sectional retrospective study included pregnant women who experienced acute life-threatening pregnancy-related adverse events at Deen Dayal Upadhyay hospital, New Delhi, India, between September 1, 2009, and August 31, 2011. Patient data were analyzed to investigate factors associated with MNM events and maternal deaths. RESULTS: There were 369 patients included, and 302 MNM events and 67 maternal deaths were recorded. The recorded causes of MNM events included hemorrhage, hypertensive disorders, severe anemia with cardiac failure, organ failure, and infection in 192 (63.6%), 62 (20.5%), 13 (4.3%), 8 (2.6%), and 8 (2.6%) patients, respectively. Higher rates of anemia (P=0.007) and infection (P=0.007) were recorded among patients in the maternal death group than the MNMN group. CONCLUSION: Hemorrhage and hypertension were major causes of MNM events and are likely major barriers to reducing maternal mortality in low-income countries. Anemia and infection were significant prognostic factors of maternal death in the present study. MNM could be used as surrogate for maternal death in the provision of standard obstetric care.
[Mh] Termos MeSH primário: Morte Materna/estatística & dados numéricos
Mortalidade Materna
Near Miss/estatística & dados numéricos
Complicações na Gravidez/mortalidade
Atenção Terciária à Saúde/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos Transversais
Feminino
Seres Humanos
Índia/epidemiologia
Gravidez
Complicações na Gravidez/epidemiologia
Prognóstico
Estudos Retrospectivos
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170514
[St] Status:MEDLINE
[do] DOI:10.1002/ijgo.12208



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