Severe acute maternal complications (near miss) in the obstetrics service of the General Hospital Teaching Ambato, period february-october 2019.

Abstract

Introduction: WHO establishes the term NEAR MISS or severe acute maternal complication to refer to those
women who were about to die, but survived a severe complication of pregnancy, childbirth or postpartum for
up to 42 days.

Objective: Evaluate the incidence of cases of serious acute maternal complications in the Gynecology and
Obstetrics Service of the General Teaching Hospital Ambato in the period February-October 2019.

Material and methods: A Transversal Descriptive Observational study was conducted, the population was
composed of all patients hospitalized in the Gynecology and Obstetrics Service of the General Teacher Hospital Ambato, who studied pregnancy, childbirth and /or postpartum in the period from February 1, 2019
to October 31, 2019.

Results: 33 cases were identified as NEAR MISS and 1 maternal death at the General Teacher Hospital
Ambato in the period February-October 2019, the ratio of Serious Acute Maternal Complications was 1.4 per
100,000 live births, the Reason for Severe Maternal Morbidity was 33 and the Maternal Mortality Rate was
2.94%. According to the WHO classification for Near Miss, the most common clinical criteria among patients
were: shock, tachypnea, bradypnea and seizures; within the laboratory criteria were platelet counts less than
50000, and PO2 <90% >1 hour and in terms of management was observed patients requiring use of
vasoactives, intubation, administration of more than 3 volumes of blood products, entry to ICU for more than
7 days and performing hysterectomy.

Conclusion: The identification of the main causes of severe acute maternal morbidity in each obstetrics
service allows the preparation of personnel for the management and resolution of obstetric emergencies based
on specific health strategies, guidelines and protocols.