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A cross sectional study of maternal 'near-miss' cases in major public hospitals in Egypt, Lebanon, Palestine and Syria.

Bashour H, Saad-Haddad G, DeJong J, Ramadan MC, Hassan S, Breebaart M, Wick L, Hassanein N, Kharouf M - BMC Pregnancy Childbirth (2015)

Bottom Line: Higher indices for the maternal mortality index were found in both Al Galaa hospital, in Egypt (8.6 %) and Dar Al Tawleed hospital in Syria (14.3 %), being large referral hospitals, compared to Ramallah hospital in Palestine and Rafik Hariri University hospital in Lebanon.Findings from this formative stage confirmed the need for quality improvement interventions.The high reported coverage of the main clinical interventions in the study hospitals would appear to be in contradiction with the above findings as the level of coverage of key evidence-based interventions was high.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medicine, Damascus University, Damascus, Syria. hyam1929@gmail.com.

ABSTRACT

Background: The maternal near-miss approach has been increasingly used as a tool to evaluate and improve the quality of care in maternal health. We report findings from the formative stage of a World Health Organization (WHO) funded implementation research study that was undertaken to collect primary data at the facility level on the prevalence, characteristics, and management of maternal near-miss cases in four major public referral hospitals - one each in Egypt, Lebanon, Palestine and Syria.

Methods: We conducted a cross sectional study of maternal near-miss cases in the four contexts beginning in 2011, where we collected data on severe maternal morbidity in the four study hospitals, using the WHO form (Individual Form HRP A65661). In each hospital, a research team including trained hospital healthcare providers carried out the data collection.

Results: A total of 9,063 live birth deliveries were reported during the data collection period across the four settings, with a total of 77 cases of severe maternal outcomes (71 maternal near-miss cases and 6 maternal deaths). Higher indices for the maternal mortality index were found in both Al Galaa hospital, in Egypt (8.6 %) and Dar Al Tawleed hospital in Syria (14.3 %), being large referral hospitals, compared to Ramallah hospital in Palestine and Rafik Hariri University hospital in Lebanon. Compared to the WHO's Multicountry Survey using the same data collection tool, our study's mortality indices are higher than the index of 5.6 % among countries with a moderate maternal mortality ratio in the WHO Survey. Overall, haemorrhage-related complications were the most frequent conditions among maternal near-miss cases across the four study hospitals. In all hospitals, coagulation dysfunctions (76.1 %) were the most prevalent dysfunction among maternal near-miss cases, followed by cardiovascular dysfunctions. The coverage of key evidence-based interventions among women experiencing a near-miss was either universal or very high in the study hospitals.

Conclusions: Findings from this formative stage confirmed the need for quality improvement interventions. The high reported coverage of the main clinical interventions in the study hospitals would appear to be in contradiction with the above findings as the level of coverage of key evidence-based interventions was high.

No MeSH data available.


Related in: MedlinePlus

Distribution of maternal complications (excluding maternal near-miss & maternal death cases), near-miss cases and maternal deaths across the four study hospitals
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Fig1: Distribution of maternal complications (excluding maternal near-miss & maternal death cases), near-miss cases and maternal deaths across the four study hospitals

Mentions: Figure 1 shows the continuum of severity of maternal outcomes in terms of proportions of maternal complications, maternal near-miss cases and maternal deaths in the four study hospitals during the study period. The highest proportion of complications was found in both the Ramallah hospital in Palestine (10.8 %) and Dar Al Tawleed hospital in Damascus, Syria (7.7 %). Lower proportions were noted in Al Galaa hospital in Cairo, Egypt and RHUH in Beirut, Lebanon (less than 3 % in both hospitals). The proportion of maternal near-miss cases was higher than 1 % in Egypt’s Al Galaa hospital and in Palestine’s Ramallah hospital.Fig. 1


A cross sectional study of maternal 'near-miss' cases in major public hospitals in Egypt, Lebanon, Palestine and Syria.

Bashour H, Saad-Haddad G, DeJong J, Ramadan MC, Hassan S, Breebaart M, Wick L, Hassanein N, Kharouf M - BMC Pregnancy Childbirth (2015)

Distribution of maternal complications (excluding maternal near-miss & maternal death cases), near-miss cases and maternal deaths across the four study hospitals
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4644334&req=5

Fig1: Distribution of maternal complications (excluding maternal near-miss & maternal death cases), near-miss cases and maternal deaths across the four study hospitals
Mentions: Figure 1 shows the continuum of severity of maternal outcomes in terms of proportions of maternal complications, maternal near-miss cases and maternal deaths in the four study hospitals during the study period. The highest proportion of complications was found in both the Ramallah hospital in Palestine (10.8 %) and Dar Al Tawleed hospital in Damascus, Syria (7.7 %). Lower proportions were noted in Al Galaa hospital in Cairo, Egypt and RHUH in Beirut, Lebanon (less than 3 % in both hospitals). The proportion of maternal near-miss cases was higher than 1 % in Egypt’s Al Galaa hospital and in Palestine’s Ramallah hospital.Fig. 1

Bottom Line: Higher indices for the maternal mortality index were found in both Al Galaa hospital, in Egypt (8.6 %) and Dar Al Tawleed hospital in Syria (14.3 %), being large referral hospitals, compared to Ramallah hospital in Palestine and Rafik Hariri University hospital in Lebanon.Findings from this formative stage confirmed the need for quality improvement interventions.The high reported coverage of the main clinical interventions in the study hospitals would appear to be in contradiction with the above findings as the level of coverage of key evidence-based interventions was high.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medicine, Damascus University, Damascus, Syria. hyam1929@gmail.com.

ABSTRACT

Background: The maternal near-miss approach has been increasingly used as a tool to evaluate and improve the quality of care in maternal health. We report findings from the formative stage of a World Health Organization (WHO) funded implementation research study that was undertaken to collect primary data at the facility level on the prevalence, characteristics, and management of maternal near-miss cases in four major public referral hospitals - one each in Egypt, Lebanon, Palestine and Syria.

Methods: We conducted a cross sectional study of maternal near-miss cases in the four contexts beginning in 2011, where we collected data on severe maternal morbidity in the four study hospitals, using the WHO form (Individual Form HRP A65661). In each hospital, a research team including trained hospital healthcare providers carried out the data collection.

Results: A total of 9,063 live birth deliveries were reported during the data collection period across the four settings, with a total of 77 cases of severe maternal outcomes (71 maternal near-miss cases and 6 maternal deaths). Higher indices for the maternal mortality index were found in both Al Galaa hospital, in Egypt (8.6 %) and Dar Al Tawleed hospital in Syria (14.3 %), being large referral hospitals, compared to Ramallah hospital in Palestine and Rafik Hariri University hospital in Lebanon. Compared to the WHO's Multicountry Survey using the same data collection tool, our study's mortality indices are higher than the index of 5.6 % among countries with a moderate maternal mortality ratio in the WHO Survey. Overall, haemorrhage-related complications were the most frequent conditions among maternal near-miss cases across the four study hospitals. In all hospitals, coagulation dysfunctions (76.1 %) were the most prevalent dysfunction among maternal near-miss cases, followed by cardiovascular dysfunctions. The coverage of key evidence-based interventions among women experiencing a near-miss was either universal or very high in the study hospitals.

Conclusions: Findings from this formative stage confirmed the need for quality improvement interventions. The high reported coverage of the main clinical interventions in the study hospitals would appear to be in contradiction with the above findings as the level of coverage of key evidence-based interventions was high.

No MeSH data available.


Related in: MedlinePlus