Women with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study

Abstract

Background Analysis of “maternal near-misses” is expected to facilitate assessment of the quality of maternity care in health facilities. Therefore, this study aimed to investigate incidence, risk factors and causes of maternal near-misses (MNM) admitted to the intensive care unit (ICU) within five years by using the World Health Organization’s MNM approach. Methods A five-year retrospective study was conducted in Subei People’s Hospital of Yangzhou, Jiangsu Province from January 1, 2015 to December 31, 2019. Risk factors in 65 women with MNM in the intensive care unit (ICU) were explored by using chi-square tests and multivariable logistic regression analysis. Causes and interventions in MNM were investigated by descriptive analysis. Results Average maternal near-miss incidence ratio (MNMIR) for ICU admission was 3.5 per 1000 live births. Average maternal mortality ratio (MMR) was 5 per 100,000 live births. MI for all MNM was 0.7%. Steady growth of MNMIR in ICU was witnessed in the five-year study period. Women who were referred from other hospitals (aOR 3.32; 95%CI 1.40–7.32) and had cesarean birth (aOR 4.96; 95%CI 1.66–14.86) were more likely to be admitted in ICU. Neonates born to women with MNM admitted in ICU had lower birthweight (aOR 5.41; 95%CI 2.53–11.58) and Apgar score at 5 min (aOR 6.39; 95%CI 2.20–18.55) compared with women with MNM outside ICU. ICU admission because of MNM occurred mostly postpartum (n = 63; 96.9%). Leading direct obstetric causes of MNM admitted in ICU were hypertensive diseases of pregnancy (n = 24; 36.9%), followed by postpartum hemorrhage (n = 14; 21.5%), while the leading indirect obstetric cause was heart diseases (n = 3; 4.6%). Conclusions Risk factors that were associated with MNM in ICU were referral and cesarean birth. Hypertensive disease of pregnancy and postpartum hemorrhage were the main obstetric causes of MNM in ICU. These findings would provide guidance to improve professional skills of primary health care providers and encourage vaginal birth in the absence of medical indications for cesarean birth.

The Association Between Severity of Anemia During Pregnancy and Severe Maternal Outcomes: A Retrospective Cohort Study

“…11,12 Infections increased the risk of severe maternal outcomes, which is consistent with Pfitscher et al 13 Pregnant women referred in from other facility, and those admitted with other comorbidities were also at an increased risk of severe maternal outcomes, which is in line with several others. 10,[14][15][16] However, some negative results were also obtained in our study, which are inconsistent with the results of other studies. 11,17 Association between multiple pregnancies and severe maternal outcomes was not observed in our study, while it was observed in a study from the WHO Multicountry survey.…”

“…Epidemiological researches have suggested that severe maternal outcomes were associated with a variety of factors, including advanced maternal age, low education level, twin pregnancies, nulliparity, no antenatal examination, history of cesarean section, and maternal complications (eg, hemorrhagic disorders, infections, hypertensive diseases). [10][11][12][13][14][15][16][17] However, most of these studies focused on direct causes of severe maternal outcomes, mainly maternal complications, rather than other indirect causes, such as anemia. 10,16 To date, almost all previous relevant studies showed that anemia during pregnancy was a contributory condition of severe maternal outcomes only by calculating the proportion of anemia among pregnant women with severe maternal outcomes, 10,16,18 yet analyses of the association between anemia during pregnancy and the risk of severe maternal outcomes were much limited, especially lacking precise estimates of the relative risk.…”

Fluorescence Sensing of Eclampsia Biomarkers via the Immunosorbent Atom Transfer Radical Polymerization Assay

“…There is a risk of life-threatening conditions such as eclampsia, liver rupture, stroke, pulmonary edema, or kidney failure . Currently, there is no effective treatment for preeclampsia, and termination of pregnancy is the only effective treatment . However, clinical manifestations and laboratory tests of preeclampsia are not very specific and can be confused with various conditions that can cause convulsions. , Recently, researchers have found that CD81 protein is related to the pathology of preeclampsia, and it has the potential to be used as a new biomarker for preeclampsia, which is expected to achieve early diagnosis and precise treatment of preeclampsia through the detection of CD81 protein. , …”

Correction to: Women with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study

“…Following publication of the original article [ 1 ], the authors identified an error in the affiliation of Xiang Kong.…”