Stillbirth in cases of severe acute maternal morbidity

Olagbuji, Biodun Nelson; Ezeanochie, Michael; Igbaruma, Solomon; Okoigi, Samson O.; Ande, Adedapo Ba

doi:10.1016/j.ijgo.2012.05.032

Cited by 11 publications

(12 citation statements)

References 18 publications

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“…The result of this Metaanalysis showed that the magnitude of still birth is higher among women who developed maternal near miss than those who deliver without complications. The result was consistent with studies conducted elsewhere that tried to investigate the risk of still birth among maternal near miss cases [12,13,20,30]. Possible explanation for this is that, the health of the mother during pregnancy and delivery is closely linked to survival of the newborn and pregnancy complications or maternal diseases are the main cause of still birth [11].…”

Section: Discussionsupporting

confidence: 90%

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Maternal Near Miss and Still birth in developing countries: A Systematic Review with Meta-Analysis

Firdawek¹,

Worku²

2015

J Preg Child Health

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Section: Discussionsupporting

confidence: 90%

“…In some of the African countries like Gambia, Nigeria and Sudan a higher risk of still birth was also observed among women of near miss when compared to women without near miss [17][18][19][20]. Hence, this is indicative of the link between still birth and maternal near miss.…”

mentioning

confidence: 93%

Maternal Near Miss and Still birth in developing countries: A Systematic Review with Meta-Analysis

Firdawek¹,

Worku²

2015

J Preg Child Health

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“…These findings cannot necessarily be extrapolated to lower‐resource settings, with significant restrictions in human resources, diagnostic capacity, and availability of obstetric interventions, however. The existing studies of perinatal mortality in LMICs have generally been limited in size (single or few institutions) and power (unable to consider stillbirth and early neonatal death as separate outcomes), despite accounting for 98% of the global burden. Previous large epidemiological surveys of perinatal deaths in LMICs have not captured data on maternal complications .…”

Section: Introductionmentioning

confidence: 99%

Maternal complications and perinatal mortality: findings of the World Health Organization Multicountry Survey on Maternal and Newborn Health

Vogel

Souza

Mori

et al. 2014

BJOG

222

215

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Objective We aimed to determine the prevalence and risks of late fetal deaths (LFDs) and early neonatal deaths (ENDs) in women with medical and obstetric complications.Design Secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS).Setting A total of 359 participating facilities in 29 countries.Population A total of 308 392 singleton deliveries.Methods We reported on perinatal indicators and determined risks of perinatal death in the presence of severe maternal complications (haemorrhagic, infectious, and hypertensive disorders, and other medical conditions).Main outcome measures Fresh and macerated LFDs (defined as stillbirths ≥ 1000 g and/or ≥28 weeks of gestation) and ENDs.Results The LFD rate was 17.7 per 1000 births; 64.8% were fresh stillbirths. The END rate was 8.4 per 1000 liveborns; 67.1% occurred by day 3 of life. Maternal complications were present in 85.6, 86.5, and 88.6% of macerated LFDs, fresh LFDs, and ENDs, respectively. The risks of all three perinatal mortality outcomes were significantly increased with placental abruption, ruptured uterus, systemic infections/sepsis, pre-eclampsia, eclampsia, and severe anaemia.Conclusions Preventing intrapartum-related perinatal deaths requires a comprehensive approach to quality intrapartum care, beyond the provision of caesarean section. Early identification and management of women with complications could improve maternal and perinatal outcomes.

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“…Maternal complications explain many severe fetal morbidities and mortalities during delivery, and thus appropriate and timely management of these complications has the potential to avoid many adverse fetal outcomes . The large disparity in stillbirth rates seen in maternal near‐miss cases across different countries, from 3.8% in Finland to as high as 46% in low‐ to middle‐income countries, is probably attributable to substandard management of complications. However, measurement challenges prevail in low‐resource settings, restricting a direct comparisons of rates across different settings.…”

Section: Introductionmentioning

confidence: 99%

“…in low-to middle-income countries, [10][11][12][13][14] is probably attributable to substandard management of complications. However, measurement challenges prevail in low-resource settings, 15 restricting a direct comparisons of rates across different settings.…”

Section: Introductionmentioning

confidence: 99%

Disentangling the contributions of maternal and fetal factors to estimate stillbirth risks for intrapartum adverse events in Tanzania and Uganda

Hirose

Alwy

Atuhairwe

et al. 2018

Intl J Gynecology & Obste

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Objective To estimate the stillbirth risk associated with intrapartum adverse events, controlling for fetal and maternal factors. Methods The present study was an analysis of cross‐sectional patient‐record and facility‐file data from women with viable fetuses who experienced obstetric adverse events at 23 hospitals and 38 health centers in Tanzania (between December 2015 and October 2016), and 22 hospitals, 16 level‐4 health centers, and five level‐3 health centers in Uganda (between May 2016 and September 2017). Adverse events were categorized in three severity groups (postpartum, intrapartum non‐near‐miss, and intrapartum near‐miss) to calculate stillbirth rates and adjusted prevalence ratios. Results Data from 3816 women in Tanzania and 8305 in Uganda were included. Compared with postpartum adverse events, intrapartum near‐miss was associated with a 3.73‐ and 4.55‐fold higher prevalence of stillbirth in Uganda and Tanzania, respectively. Most women who experienced near‐miss had organ dysfunction on arrival or developed it soon after. The risk of stillbirth was higher among preterm deliveries compared with term deliveries, and was 42% and 59% lower in Tanzania and Uganda, respectively, for cesarean deliveries compared with vaginal deliveries after intrapartum non‐near‐miss adverse events. Conclusion Stillbirth risk increased with severity of complications and was higher among premature deliveries. Survival was higher for cesarean deliveries in intrapartum non‐near‐miss complications, identifying the opportunity to prevent deterioration by timely actions.

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Stillbirth in cases of severe acute maternal morbidity

Abstract: In Nigeria, SAMM was found to be associated with an unacceptably high rate of stillbirth. Strategies to improve fetal surveillance among women with SAMM are necessary to address the excessively high incidence of stillbirth among these patients.

Cited by 11 publications

References 18 publications

Maternal Near Miss and Still birth in developing countries: A Systematic Review with Meta-Analysis

Maternal Near Miss and Still birth in developing countries: A Systematic Review with Meta-Analysis

Maternal complications and perinatal mortality: findings of the World Health Organization Multicountry Survey on Maternal and Newborn Health

Disentangling the contributions of maternal and fetal factors to estimate stillbirth risks for intrapartum adverse events in Tanzania and Uganda

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