A Stitch in Time Saves Nine: Severe Maternal Morbidity and its Related Maternal Outcome

  • Bushra Bano Allama Iqbal medical college
  • Saira Yunus Department of Obstetrics and Gynecology Jinnah Hospital Lahore
  • Saba Yousaf Medical Officer, Department of Obstetrics and Gynecology Jinnah Hospital Lahore
  • Amtullah Zareen Professor, Department of Obstetrics and Gynecology Jinnah Hospital Lahore
  • Nishat Akram Associate Professor, Sharif medical city, Lahore
  • Sara Saeed Assistant Professor,Department of Obstetrics and Gynecology Jinnah Hospital Lahore
Keywords: Hypertensive disorders, Obstetric hemorrhage, severe maternal morbidity

Abstract

Objective: To determine causes of severe maternal morbidity and its associated outcome.
Methodology:This is a prospective cross sectional , Jinnah hospital Lahore from January 2019- December 2019.A total of 104 subjects in critical condition requiring ICU admission presenting in antenatal and postpartum period within 42 days after childbirth regardless of gestational age, were selected according to the definition of ICD “Any health condition attributed to and /or aggravated by pregnancy and child birth has a negative impact on the woman’s wellbeing” (International  Classification of Diseases).1 All cases were assessed and provided immediate managementand its related outcome was recorded.  The data was analyzed SPSS 21.0 and was presented as frequency and percentages.
Results: A total of 104 cases were evaluated. The mean age was 27.11±5.32 years. There were97(93.3%) cases as unbooked and referred forming the bulk of severe morbidities, as compared to booked cases 7(6.7%), 30 (28.8%) had hypertensive disorders,20 (19.2%) had post-partum hemorrhage cases, 13 (12.5%) had ruptured uterus, Cardiac disease were 10 (9.62%).19 cases(18.3%) needed massive blood transfusion (> 10pints) Maternal mortality was observed in 26 (25.0%) cases. 72 (78.8%) cases survived with immediate surgical intervention as Emergency LSCS, exploratory laparotomy, hysterectomy.
Conclusion: Hypertensive disorders followed by postpartum hemorrhage and ruptured uterus were the most common causes of severe maternal morbidities. Immediate and quick response and early required intervention in obstetrical emergencies are associated with improved maternal outcome.

Published
2021-03-23
Section
Original Articles