Near-miss o casi pérdida en un hospital de referencia

Objectives

To analyze maternal health from direct mortality and the concept of near-miss at La Fe University Hospital in Valencia (Spain) from 1991 to 2007.

Material and methods

We calculated the direct maternal mortality ratio (DMMR) from 1971-2007 and the severe obstetric morbility-mortality ratio from 1991-2007, and analyzed their causes.

Results

A significant DMMR decrease (rho = - 1), with a significant reduction in mortality due to cardiovascular disease was found. When analyzing severe maternal morbidity, we observed an increase of placenta previa (OR = 1.79), abruptio placentae (OR = 1.35), uterine rupture (OR = 2.48) and anesthetic complications (OR = 6.20), with a significant decrease of postpartum hemorrhage (OR = 0.63) and severe puerperal infection (OR = 0.32).The prevalence of hypertensive disorders of pregnancy, thromboembolic disease, intrauterine fetal death and severe morbidity/mortality ratio remained stable during the study period.

Conclusions

Estimating the severe obstetric morbidity-mortality ratio due to different near-miss definitions in the literature is difficult. The DMMR decreased, while the morbidity/mortality ratio remained stable.