Extreme maternal morbidity in the Peruvian Instituto Nacional Materno Perinatal, experience and results

Ríos E.G. · Revista Peruana de Ginecologia y Obstetricia (2024) · DOI: 10.31403/rpgo.v70i2627

Resumen

Introduction: Extreme maternal morbidity (EMM) is an indicator for estimating the quality of obstetric care in pregnant or postpartum women with severe morbidities who survive because of the care received in obstetric services. Objective: To determine the causes, dysfunctions and morbidity and mortality indicators of cases of extreme maternal morbidity attended at the Instituto Nacional Materno Perinatal between 2017 and 2023 and the results of their care. Methodology: We reviewed the medical records of pregnant women with EMM criteria, determining causes, dysfunctions, care and evolution, evaluating the results with morbidity and mortality indicators. Results: In the 1,931 medical records of women with MME, the predominant etiology was preeclampsia with 911 cases (47.2%) followed by postpartum hemorrhage with 359 cases (18.6%). The most frequent dysfunctions between 2017 and 2020 were hepatic, respiratory and coagulation dysfunctions and, from 2021 onwards, coagulation and cardiac dysfunctions. The MME ratio ranged from 12.7 to 26.1 x 1,000 live births. Since 2017, the case fatality indicator is 1.8 maternal deaths (MM) x 100 MME cases, and the MME/MM ratio has remained higher than 35 MME cases x 1 MM case. The criterion/case ratio in 2023 was 2.2, reflecting the severity of the cases. Conclusion: The good quality of care of the INMP service in MME cases points to this indicator as a strategy to reduce maternal mortality in the country.

Instituciones: Universidad Nacional Mayor de San Marcos