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      Morbilidad materna extremadamente grave. Un problema obstétrico en la salud pública y la atención al paciente grave Translated title: Extremely serious maternal morbidity. An obstetric problem in public health and seriously ill patient care

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          Abstract

          El concepto morbilidad materna extremadamente grave, se considera de gran utilidad al ser un indicador muy asociado a la muerte materna y un estadio intermedio en prácticamente la totalidad de las fallecidas. Como parte de la primera etapa de un proyecto de investigación se realizó una revisión del tema y se consultaron las bases de datos LILACS, EBSCO e HINARI. Los descriptores que se utilizaron fueron: mortalidad materna, morbilidad y paciente obstétrica grave. Los resultados de la búsqueda se limitaron a los últimos cinco años en idioma inglés, español, francés y portugués. La morbilidad materna extremadamente grave es un indicador muy asociado a la muerte materna y es considerada una alternativa válida para utilizarla como indicador de la calidad de los cuidados maternos. El interés creciente de integrar el análisis de la morbilidad materna extremadamente grave al estudio de la mortalidad materna, permite identificar los factores de riesgo presentes en las gestantes, desde un embarazo sin complicaciones hasta la muerte, pues se presenta en un mayor número de casos, y con el manejo de aquellos que evolucionaron favorablemente después de la gravedad extrema, se pueden evitar nuevas defunciones.

          Translated abstract

          The concept “extremely serious maternal morbidity” is considered very useful because it is an indicator closely associated to maternal death and an intermediate stage in practically the totality of maternal deceases. As a part of the first stage of a research project, a review on the theme was carried out, and LILACS, EBSCO and HINARI data bases were consulted. The used descriptors were: maternal mortality, morbidity and seriously ill obstetric patient. The results of the search were limited to the last five years in English, Spanish, French and Portuguese languages. Extremely serious maternal morbidity is an indicator very frequently associated to maternal death, and it is considered a suitable alternative for using it as an indicator of the maternal care quality. The increasing interest for integrating the analysis of extremely serious maternal morbidity to the study of maternal morbidity allows identifying the risk factors that are present in pregnant women, beginning from a pregnancy without complications and ending with death, because they are found in a bigger quantity of cases, and new deceases could be avoided with the management of those favourably evolving after the extreme seriousness.

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          Frequency of and factors associated with severe maternal morbidity.

          To estimate the frequency of severe maternal morbidity, assess its underlying etiologies, and develop a scoring system to predict its occurrence.Supplemental Digital Content is Available in the Text.
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            Clima organizacional en la gestión del cambio para el desarrollo de la organización

            En la actualidad el clima organizacional es un tema de gran importancia para las organizaciones que encaminan su gestión en el continuo mejoramiento del ambiente de trabajo, por ello se considera que es un factor clave en el desarrollo de las instituciones y su estudio en profundidad, diagnóstico y mejoramiento incide de manera directa en el denominado espíritu de la organización. Por lo anterior, en el presente trabajo se realiza una aproximación conceptual al tema, que permite demostrar la importancia del clima en la gestión del cambio en los sistemas organizacionales. De igual forma, se exponen las diferentes dimensiones y categorías a tener en cuenta para su medición las cuales giran en torno a los valores de la organización, las creencias, costumbres y prácticas institucionales, que permiten esclarecer las causas de la satisfacción e insatisfacción en el trabajo y su incidencia en los cambios organizacionales.
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              The prevalence of severe maternal morbidity and near miss and associated factors in Sergipe, Northeast Brazil

              Background The investigation of severe maternal morbidity (SAMM) and maternal near miss (NM) and associated risk factors is important for the global reduction of maternal mortality. This study investigated the prevalence of SAMM and NM cases and the associated risk factors in two reference maternity hospitals in a capital city in Northeast-Brazil. Methods A cross-sectional study with a nested case–control component was conducted from June-2011 to May-2012. Case identification was prospective and data collection was performed according to WHO criteria and definitions. Odds ratio with confidence intervals and multivariate analysis were used whenever possible. Results There were 16,243 deliveries, 1,102 SAMM cases, 77 NM cases and 17 maternal deaths. The maternal NM outcome ratio was 5.8 cases/1,000 live births (LB); the total prevalence of SAMM + NM was 72.6 cases/1,000 LB, the maternal near miss: mortality ratio was 4.5cases/1 maternal death (18% of mortality index). Management-based criteria were the most common events for NM (87.1%) and hypertensive disorders for SAMM (67.5%). Higher age, previous abortion and caesarean delivery, the non-adhesion to antenatal care, current caesarean delivery and bad perinatal results were associated with SAMM/NM. In the multivariate analysis, patient’s status, previous caesarian and abortion and level of consciousness were significant when analyzed together. Conclusions SAMM and NM situations were prevalent in the studied population and some risk factors seem to be associated with the event, particularly previous gestational antecedents. Protocols based on SAMM/NM situations can save lives and decrease maternal mortality.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rme
                Revista Médica Electrónica
                Rev.Med.Electrón.
                CENTRO PROVINCIAL DE INFORMACIÓN DE CIENCIAS MÉDICAS. MATANZAS (Matanzas, , Cuba )
                1684-1824
                October 2017
                : 1117-1125
                Affiliations
                [01] Matanzas orgnameUniversidad de Ciencias Médicas de Matanzas Cuba
                [02] Matanzas orgnameHospital Universitario Provincial Clínico Quirúrgico Comandante Faustino Pérez Hernández Cuba
                Article
                S1684-18242017000500011
                a0882f68-de08-4c24-b3a6-0de132992af0

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 24 March 2017
                : 06 July 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 33, Pages: 9
                Product

                SciELO Cuba


                seriously ill obstetric patient,extremely serious maternal morbidity,paciente obstétrica grave,morbilidad materna extremadamente grave,maternal morbidity,morbilidad materna

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