Main Causes Of Maternal Mortality Research Articles

Research Priorities for Preventing Unsafe Abortions in the WHO Africa Region

Background: Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a main cause of maternal mortality and morbidity. This paper has considered questions that have the greatest potential to successfully reduce unsafe abortions in the resource poor settings. Methods: We adapted the Child Health and Nutrition Research Initiative (CHNRI) to identify and prioritize many competing sexual and reproductive health and rights research ideas that impact the health of the populations. The implementation was done in three phases which included generation and collection of research ideas from various experts virtually in August 2019 consolidation of the potential questions through thematic analysis conducted in September 2019. Finally, scoring and ranking of the research questions was done in a workshop of experts. Results: Out of a list of 45 priority research questions, two questions were ranked the highest scoring 28 out of the possible 30. The research priorities include: “The effectiveness of interventions (e.g. counseling or incentives or home visits) to increase post abortion uptake and continuance”, “Reducing repeat abortion on improving maternal health outcomes” and “Evaluation of community-based awareness programs to reduce unwanted pregnancies and encourage women to seek help early”. Conclusions: Ten key research priorities in preventing unsafe abortion were identified. The priority list covers areas of focus that could effectively impact preventing unsafe abortions while also acting as a knowledge base for researchers, policy makers and other interested stakeholders who would want to invest in this area.

Potential of Immune-Related Genes as Biomarkers for Diagnosis and Subtype Classification of Preeclampsia.

ObjectivePreeclampsia is the main cause of maternal mortality due to a lack of diagnostic biomarkers and effective prevention and treatment. The immune system plays an important role in the occurrence and development of preeclampsia. This research aimed to identify significant immune-related genes to predict preeclampsia and possible prevention and control methods.MethodsDifferential expression analysis between normotensive and PE pregnancies was performed to identify significantly changed immune-related genes. Generalized linear model (GLM), random forest (RF), and support vector machine (SVM) models were established separately to screen the most suitable biomarkers for the diagnosis of PE among these significantly changed immune-related genes. The consensus clustering method was used to divide the PE cases into several subgroups to explore the function of the significantly changed immune-related genes in PE.ResultsThirteen significantly changed immune-related genes were obtained by the differential expression analysis. RF was the best model and was used to select the four most important explanatory variables (CRH, PI3, CCL18, and CCL2) to diagnose PE. A nomogram model was constructed to predict PE based on these four variables. The decision curve analysis (DCA) and clinical impact curves revealed that PE patients could significantly benefit from this nomogram. Consensus clustering analysis of the 13 differentially expressed immune-related genes (DIRGs) was used to identify 3 subgroups of PE pregnancies with different clinical outcomes and immune cell infiltration.ConclusionOur study identified four immune-related genes to predict PE and three subgroups of PE with different clinical outcomes and immune cell infiltration. Future studies on the three subgroups may provide direction for individualized treatment of PE patients.

Maternal mortality following thromboembolism; incidences and prophylaxis strategies

BackgroundThromboembolism is one of the main causes of maternal mortality, which can be prevented in many cases. The present study was designed to investigate the incidence and prophylaxis strategies for maternal mortality following thromboembolism in postnatal.MethodsIn this case series study, the data of the mortality cases were extracted according to the ethical and security standards of the Ministry of Health of the country and compared with a healthy control group. The thromboembolism risk factors measured and scored using a questionnaire entitled “the evaluation of risk factors for maternal mortality following thromboembolism during pregnancy, labor, or post-partum”.ResultsThe maternal mortality rate was 16 per 100,000 live births. Among 297 mortality cases, 27 (9%) death were due to thromboembolism. The mean gestational age was 32.5 weeks. Dyspnea (88.8%) and tachycardia (18.5%) were found as common clinical manifestations in these patients. Sixteen cases (59.3%) did not get heparin, 6 (22.2%) received single dose and 5 (18.5%) received two doses and more. In these 11 cases, 5 (45%) patients received heparin before surgery, 1 after surgery, and 5 before and after surgery. Twenty cases deceased in the first hours after delivery and the rest after 2 to 12 days. The average score of risk for thromboembolism based on Royal College of Obstetricians & Gynecologist (RCOG) guideline was 4.6.ConclusionIt seems that one of the most important cause of maternal mortality in this study was the lack of recognition of high-risk patients and the lack of prescription for prophylaxis with heparin and this clearly explains the need for accurate screening of high-risk mothers, designing a standard form and the care and treatment of these patients.

Hubungan Antara Preeklampsia dengan Kejadian Berat Badan Lahir Rendah di RSUD Dr. Soedarso Pontianak Tahun 2018

Research: Pre-eclampsia is a disease with signs of hypertension, edema, and proteinuria arising from pregnancy. This disease generally occurs in the third trimester of pregnancy, but can occur earlier, for example in hydatidiform mole (Wiknjosastro, 2005: 282). Preeclampsia and Eclampsia are one of the main causes of maternal mortality in Indonesia. The incidence of preeclampsia ranges from 5-15% of all pregnancies in the world. Based on the 2003 Indonesian Demographic and Health Survey (IDHS), the incidence of preeclampsia in Indonesia is estimated at 3.4–8.5%. The research method used analytical observational method through a case control approach, which is an analytical study concerning how risk factors are studied using a retrospective approach. In other words, the effect is identified now, then the risk factor is identified as having existed or occurred in the past. Research Results The results of the significance test using the Chi-Square test showed a significant relationship to the occurrence of low birth weight (LBW) in mothers with preeclampsia. This is indicated by the value of p = 0.000 which is smaller than α = 0.05, so Ho is rejected. While the results of the calculation of the Odds Ratio show that preeclampsia is one of the causes of LBW, this is indicated by the OR value of 3.028. Conclusion: There is a relationship between preeclampsia and low birth weight in dr. Soedarso Pontianak in 2018 with a probability value (ρ) = 0.000.

Root-Cause Analysis of Maternal Mortality in Fars Province, Southern Iran 2014: Negligence Is the Prime Suspect.

Objective: we aimed to carry out an applied methodological tool, using Root-Cause Analysis (RCA), to determine the main causes of maternal mortality in Fars province, south of Iran, in 2014. Materials and methods: This is a case-series study and was conducted based on a careful examination of records and verbal autopsy with the family of the deceased person and their medical care team. Using RCA, quantitative dynamic modeling was done to display the overall impacts of different causes on maternal mortality. Finally, sensitivity analysis was done to determine the magnitude of contribution of each root-cause of maternal mortality. Results: Totally, all 10 maternal deaths with Maternal Mortality Rate (MMR) of 13.4 per 100.000 births, were recorded in the maternal surveillance system during 2014. The RCA results revealed that the root-causes of maternal mortality were ignorance and negligence (50%), delay in diagnosis (30%), delay in service provision in the first 24 hours after delivery (10%), and undesirable health care (10%). The results of sensitivity analysis in different scenarios revealed that medical negligence had the highest contribution to maternal mortality. Conclusion: Although maternal surveillance system stated some causes such as hemorrhage to be responsible for maternal deaths, the RCA showed that root-causes such as medical neglects had a fundamental role. Therefore, maternal mortality can be prevented by reforming the health care system and training all service providers, especially for high-risk mothers.

Opportunities and Challenges for Improving Anti-Microbial Stewardship in Low- and Middle-Income Countries; Lessons Learnt from the Maternal Sepsis Intervention in Western Uganda.

This paper presents findings from an action-research intervention designed to identify ways of improving antimicrobial stewardship in a Ugandan Regional Referral Hospital. Building on an existing health partnership and extensive action-research on maternal health, it focused on maternal sepsis. Sepsis is one of the main causes of maternal mortality in Uganda and surgical site infection, a major contributing factor. Post-natal wards also consume the largest volume of antibiotics. The findings from the Maternal Sepsis Intervention demonstrate the potential for remarkable changes in health worker behaviour through multi-disciplinary engagement. Nurses and midwives create the connective tissue linking pharmacy, laboratory scientists and junior doctors to support an evidence-based response to prescribing. These multi-disciplinary ‘huddles’ form a necessary, but insufficient, grounding for active clinical pharmacy. The impact on antimicrobial stewardship and maternal mortality and morbidity is ultimately limited by very poor and inconsistent access to antibiotics and supplies. Insufficient and predictable stock-outs undermine behaviour change frustrating health workers’ ability to exercise their knowledge and skill for the benefit of their patients. This escalates healthcare costs and contributes to anti-microbial resistance.

THE ROLE OF ULTRASOUND AND COLOR DOPPLER IN PREDICTION OF PLACENTAL MYOMETRIAL INVASION IN WOMEN WITH PLACENTA PREVIA AND A PRIOR CESAREAN DELIVERY

Background: Placenta accreta is considered a life-threatening condition and the main cause of maternal mortality, postpartum hysterectomy, admission to ICU, and an inadvertent laceration to intestine or bladder during cesarean section. Objectives: To evaluate the efficacy of transabdominal ultrasonography and color Doppler in prediction of placental myometrial invasion in patients with prior cesarean delivery. Patients and methods: This prospective study was conducted at El-Galaa teaching maternity hospital in ultrasound unit, emergency department, and operation theatre where 100 pregnant women with gestational age of 30 weeks or more whose placentae were anterior and previa with previous cesarean deliveries by Trans abdominal real-time imaging Results: Sensitivity, specificity, PPV, NPV, and accuracy of ultrasound in diagnosis of PA were 92.5%, 90.0%, 86.0%, 94.7%, and 91.0%, respectively. The detection of intraplacental lacunae has the highest positive predictive value (95.5%).with high sensitivity (92%). Conclusion: The presence of intraplacental lacunae had the highest sensitivity for detection of PA and the use of a two‐criteria system allowed a good compromise between sensitivity and specificity, with high PPV and NPV.

Clasificación de riesgo para enfermedad tromboembólica venosa y tromboprofilaxis durante el puerperio, Tunja 2017

Introducción. La mortalidad materna se define como la muerte durante el embarazo o el puerperio, por causas relacionadas con la gestación. Las principales causas de mortalidad materna han variado en países desarrollados, donde la enfermedad tromboembólica venosa se encuentra en ascenso. Objetivo. Evaluar el nivel de riesgo para enfermedad tromboembólica venosa en el puerperio, en pacientes atendidas en la clínica Esimed de Tunja, año 2017. Método. Estudio observacional con diseño transversal analítico en una población de 1538 gestantes, con una muestra de 304 pacientes seleccionadas mediante muestreo aleatorio simple, a partir de la base de datos reportada por el sistema de información de la institución prestadora de salud. Se tuvieron en cuenta variables sociodemográficas, así como vía del parto, presencia de clasificación de riesgo para enfermedad tromboembólica venosa en la historia clínica y empleo de tromboprofilaxis. Resultados. Se encontró mayor probabilidad de tener parto por cesárea en pacientes mayores de 35 años, con respecto al grupo de comparación. Un 75,9% de la población no presentó clasificación de riesgo para enfermedad tromboembólica venosa, por tanto, solo el 10,1% presentó indicación de tromboprofilaxis en pacientes que la requerían. Conclusiones. Es necesario realizar una adecuada clasificación de riesgo a todas las pacientes que están siendo atendidas en la institución; así como la relevancia de controlar los factores de riesgo que mayor implicación demostrada tienen para el desarrollo de enfermedad tromboembólica venosa, como es el caso de la cesárea.

Акушерские причины материнской смертности. Результаты патологоанатомических исследований

Objective. To study the main causes of maternal mortality and to determine the role of obstetrical pathologies based on the findings of pathoanatomical autopsies. Materials and methods. The study included 42 autopsy findings, we studied medical documentation, autopsy records of deceased pregnant and parturient women. The most common causes of mortality (n = 29), according to the latest revision of ICD-10, were analyzed in detail. The general clinical and morphological examination was performed. Results. In Moscow, more than half of cases in the structure of maternal mortality refer to obstetrical pathologies. The most significant role belongs to preeclampsia and eclampsia (28.6%), they are in most cases characterised by an atypical clinical course and a specific pathomorphological picture. The second place is taken by massive pulmonary embolism (9.5%), the third place belongs to maternal shock during labour (7%) and the fourth place is shared by intrapartum infection (obstetrical sepsis), complications associated with obstetrical operative intervention and procedures, postpartum cerebral venous thrombosis, amniotic fluid embolism, postpartum cardiomyopathy (4.8%). Conclusion. The leading position in the structure of maternal mortality due to obstetrical causes belongs to preeclampsia and eclampsia. This pathology requires a complex approach to diagnosis and treatment, and postmortem verification of diagnosis should be confirmed by morphological examination with the use of immunohistochemical reactions. Key words: maternal mortality, obstetric pathology, preeclampsia and eclampsia, pulmonary embolism, maternal shock, obstetrical sepsis

Trends and Causes of Maternal Mortality in West of Iran from 2002 to 2016: Implications for Sustainable Development Goals

ABSTRACT Background The mortality rate is one of the most important indicators that represent the socioeconomic development of the country. To reduce maternal mortality rate, it is vital to recognize the trend and causes of maternal mortality. This study aimed to determine the mortality rate and causes of maternal mortality in Hamadan province from 2002 to 2016. Materials and methods The study was performed as a retrospective descriptive study in Hamadan province. To investigate the causes of mothers’ death in Hamadan province, the data were extracted from the maternal care system for 2002 to 2016. Furthermore, locally weighted scatter smoothing (LOWESS) method was used to smooth the trend of the mortality rate. The data analysis was carried out using STATA software. Results The maternal mortality rate has reduced from 35 per 100,000 live births in 2002 to 14 per 100,000 live births in 2016. The most important causes of maternal mortality in Hamadan province were bleeding and preeclampsia, Also the majority of deaths occurred in the hospital. Conclusion The rate of maternal mortality in Hamadan has a decreasing trend and is met for the United Nations Sustainable Development Goals (SDGs) before 2030. Despite the decline, the cause of death by blood and bleeding remains as the main causes of maternal mortality. To reduce maternal mortality, all women need to be provided with the equal access to prenatal and post-pregnancy complications during pregnancy, sex education, and family planning. How to cite this article Javaheri M, Mohammadi Y. Trends and Causes of Maternal Mortality in West of Iran from 2002 to 2016: Implications for Sustainable Development Goals. J South Asian Feder Obst Gynae 2020;12(3):159–162.

Stopa i uzroci smrtnosti majki u južnom Iranu

The maternal mortality rate (MMR) often reflects the development status of one country. This study calculates the incidence rate of maternal mortality and examines the related risk factors in Fars Province, located in South of Iran. Using the surveillance system of Shiraz University of Medical Sciences, we reviewed all childbirth records from 2002 to 2012 in which maternal mortality occurred. Of 747,077 pregnancies, the average MMR was 21.28 per 100,000 live births per year, with a decreasing but non-significant trend. In rural areas, the MMR was more than twice as high as in urban areas. The most common cause of maternal death was maternal hemorrhage (27%), followed by pre-eclampsia (15.7%) and infections (13.2%). Although the MMR gradually decreased, this decrease was not significant. Based on the higher MMR in rural areas, maternal and specialty post-partum care in rural areas should be improved and promoted. Hemorrhage is still the main cause of maternal mortality in Fars Province. Since high percentage of these cases are preventable, increased healthcare during pregnancy, reduction of cesarean sections, more well-equipped facilities, and hemorrhage-control teams in maternity hospitals would likely have a significantly positive impact on MMR.

Social Determinant Relationship with the Pre-eclampsia Events; A Research Cross Sectional

The main cause of maternal mortality is pre-eclampsia as many as 2 out of 5 maternal deaths. The severe complication ratio is 218/1000 and the mortality ratio of pregnant women is 198/1000. Hypertension accounted for 16 (28.1%) of 57 cases with severe complications both bleeding and abortion were 14 (24.6%). MDG’s Targets 1 to 3 in social factors contribute to the incidence of pre-eclampsia. The aim of this is to analyze the research that has three social determinan whiach are age, education and occupation associated with the incidence of pre-eclampsia. Design of this Research was a survey with a cross - sectional study approach, which was carried out from June 23 to July 28, 2018 at the Bontomanai Health Center in Jeneponto District. A sample of 45 women who experienced pre-eclampsia from January 2016 to June 2018. Data analysis with Logistic Regression is used to link dependent and independent variables. Variable proximity is seen using Odds Ratio (OR). The division of the Pre-eclampsia category is divided into two categories, namely as many as 26 people (57.8%) and mild pre-eclampsia as many as 19 people (42.2%). There are three variables in this study, age, education and occupation. Of the three variables, only age is significant while education and employment have no significance. Therefore, it can be concluded that: Subsequent research into the relationship of health status, culture with pre-eclampsia.

Post-partum Hemorrhage and Anemia as its Modifiable Risk Factor: A Literature Review

<p>Maternal mortality is an indicator of a country’s health status. Postpartum hemorrhage is the main cause of maternal mortality. Understanding the postpartum hemorrhage risk factors useful to develop strategy in order to reduce maternal mortality. The aim of this study was to find modifiable postpartum hemorrhage's risk factors. This study used 6 steps which include formulating the research questions and objectives, searching the extant literature, screening for inclusion, assessing the quality of primary studies, extracting data, and analyzing data. The article was searched from Google Scholar and NCBI databases using bilingual keywords: "faktor-faktor, perdarahan postpartum, risk factors, and postpartum hemorrhage". There were 1736 papers founded and only 14 articles met the inclusion criteria and included in the analysis. The review revealed that anemia, age, parity, birth passage laceration, obstetric history, multiple pregnancy, placental retention, prolonged labor, atonia uteri, pre-eclampsia, pregnancy induced hypertension, section caesarian, placental complication, history of post-partum hemorrhage, episiotomy, high neonatal birth weight. Anemia is the only modifiable risk factor which may be prevented by nurses. </p>

Early Breastfeeding Initiation of Postpartum Hemorrhage Events

Hemorrhage was the main cause of maternal mortality in Tegal, 2017. Based on the survey at Puskesmas Slawi in January-December 2018, 30 women gave birth and experienced postpartum hemorrhage. Early breastfeeding helps to reduce hemorrhage and shrink uterus after birth. The research analyzed the effect of Early Initiation of Breastfeeding towards postpartum hemorrhage at Puskesmas Slawi. The population was 215 women who gave birth at Puskesmas Slawi in January-December 2018 with 140 samples. The research design applied case control study. Based on Chi Square with α = 0.05, p value was 0.048. It means that there was a relationship in both variables. As the result of logistic regression test, Sig. value was 0.029 stating that there was an effect of those variables. OR value was 2.495 meaning that mothers who performed early initiation of breastfeeding were 2.5 times lower risk at postpartum hemorrhage than those who did not act early initiation of breastfeeding. Asymp. Sig (2-Sided) was 0.032 describing that it represented population.Thus, there were a relationship and an effect of Early Initiation of Breastfeeding towards postpartum hemorrhage at Puskesmas Slawi.

Uterine artery embolization in obstetrics

Introduction. We did not find any publications or mentions in the Ukrainian medical segment of the Internet and special medical literature about previously performed similar operations (simultaneous caesarean section and embolization of the uterine arteries directly at the moment of birth), which allows us to consider the two operations performed «Prophylactic selective transcatheter embolization of uterine arteries» in pa­­tients with placenta previa percreta the first in Ukraine. Background. The prevalence of placenta previa and placenta percretaincreases from year to year as a result of an increase in the number of cesarean sections. Because of this, the percentage of women at high risk of massive life-threatening bleeding is also increasing. Predictions around the world show that the incidence of cesarean section will increase, which will lead to an increase in the number of placenta previa and placenta increta and thereafter maternal mortality, since the main cause of maternal mortality is bleeding (about 35 % of cases). The aim study was to asses of the effect of preventi­­ve selective embolization of uterine arteries with placenta previa percreta on the volume of blood loss during delivery, and the possibility of preserving the uterus and the reproductive function of women. Material and methods. In 2018—2019, we per­­formed two prophylactic selective transcatheter em­­bolizations of the uterine arteries in patients with placenta previa percreta. The delivery of these patients took place in the form of simultaneous endovascular embolization of the uterine arteries during cesarean section. The delivery algorithm was as follows: the first stage was the contralateral catheterization of the uterine arteries by transfemoral access. Next, corporal cae­sarean section was performed. After extraction of the fetus and clamping of the umbilical cord, uterine arteries were selectively embolized until the blood flow through them was completely stopped. Then, sepa­­ration/dissection of the placenta, metroplasty and suturing of the wound were performed. At the end of the operation, catheters from the uterine arteries were removed. Results and discussion. The entire embolization procedure (in total: from puncture of the femoral arteries to control angiography after embolization) took 27 minutes in the first case and 38 minutes in the second. The longer embolization time in the second case is partially associated with unilateral access and alternate catheterization of the uterine arteries. This was done to minimize post-procedural complications of the site of puncture of the femoral artery. Unfortunately, the technical conditions for these embolizations did not allow transradial access, which is possible from a practical point of view. The postpartum period was without complications. As the experience of these two operations showed, it was not possible to achieve the fullness of the «dry uterus» by embolization of the uterine arteries, but the volume of blood loss taking into account reinfusion in the form of washed red blood cells turned out to be lower than the median values of most cases and published studies described in foreign literature. Conclusions. Preventive selective transcatheter em­­bo­­lization of the uterine arteries before birth/removal of the placenta can be considered as a good preventi­­on of primary postpartum hemorrhage and thus to provide organ rescue. In pregnant women of high-risk groups, it is better to carry out catheterization of the uterine arteries in a planned manner before delivery, simultaneously with cesarean section, which is technically simpler.

HUBUNGAN PREEKLAMPSIA BERAT DENGAN KOMPLIKASI PADA JANIN DI RSUD ABDUL 2 WAHAB SJAHRANIE SAMARINDA 3 TAHUN 2017-2018

Preeclampsia defined as new onset of hypertension and proteinuria after 20 weeks of gestation. Preeclampsia is one of the three main causes of maternal mortality with an incidence of 128,273 each year or around 5.3% in Indonesia. Preeclampsia is classified as preeclampsia without severe features and severe preeclampsia. Severe preeclampsia can be a problem, both in the mother and the fetus due to vascular vasospasm. If uteroplacental blood flow to the fetus is limited, the fetus can be born under low birth weight (LBW), preterm birth, intra uterine fetal death, and low Apgar score. The aim of this research is to determine the correlation of severe preeclampsia with fetal complication, that is intra uterine fetal death (IUFD), preterm labor, neonatal asphyxia, and low birth weight (LBW). The design of this research is case control study with 46 sample for both case and control groups. The data analysis used chi-square for 2x2 table and likelihood ratio for 2x3 table. The results of this this research is showed that there was correlation between severe preeclampsia with preterm labor (p=0,000)and severe preeclampsia with low birth weight (p=0,000), there was no correlation between severe preeclampsia with IUFD (p=0,822) and severe preeclampsia with neonatal asphyxia (p=0,060)

Empowering midwives to manage postpartum haemorrhage in rural areas of Islamic Republic of Iran: lessons learnt from cases of maternal death.

Postpartum haemorrhage is the main cause of maternal mortality in rural areas of low-income countries. This study investigated the causes of maternal death from postpartum haemorrhage in rural areas of Sistan and Baluchestan, Islamic Republic of Iran, and determined the effect of three interventions on midwives' management of haemorrhage. Maternal deaths in women with postpartum haemorrhage between 9 April 2012 and 9 April 2013 were reviewed to determine what contributed to the death. Following the review, prostaglandin was permitted for use in rural maternity units. A flowchart on managing haemorrhagic shock and a training workshop on management of postpartum haemorrhage were also developed for midwives working in rural areas. After the interventions, all cases of postpartum haemorrhage (n = 81) that occurred during 23 September 2014-23 February 2015 in rural maternity facilities were reviewed based on 19 indicators. A control group (n = 81) was selected from women with postpartum haemorrhage who had been admitted to the same maternity units before the interventions. After the training interventions, more midwives used more than one method to estimate blood loss and higher doses of oxytocin to control haemorrhage. They showed improvements in the use of intravenous fluid therapy, pulse and blood pressure checks, external uterine massage, and uterotonic drugs. Following training, more women were admitted to hospital in a stable condition and recovered and were discharged (P = 0.002), and fewer had surgical interventions (P = 0.007). Midwives' management of postpartum haemorrhage improved after the interventions. Training programmes should be based on study of the local situation to identify shortcomings. Regular monitoring of outcomes is needed to detect and resolve failures.

Interventions and Management of Postpartum Hemorrhage: A Literature Review

Bleeding is the main cause of maternal mortality in the world, the mortality rate due to bleeding about 30.3% in Indonesia in 2013. Dealing bleeding during and after labor is very important for health professionals including nurses. Research on the management of postpartum hemorrhage is still limited. The purpose of this literature review was to determine the management of postpartum hemorrhage from various countries. The method, this literature review involved articles that published in 2008-2018. The articles searched from several databases, including ProQuest, 32 articles, PubMed 22 articles, and Google 21 scholar articles. Keywords for article search included postpartum hemorrhage, nurse, prevention, treatment, management, and intervention. 75 articles were assessed for the quality using the JBI instrument (Joanna Briggs Institute), and finally, 10 articles were found and met the inclusion criteria. The results show that there are two types of actions to deal with postpartum hemorrhage including direct treatment and indirect treatment. The direct treatment includes bimanual compression, maneuvering techniques, balloon tampons, and tools resembling a butterfly shape for bimanual compression. Indirect actions include training of health workers, initiation of early breastfeeding and ice packs. Conclusion, effective management both directly and indirectly is able to overcome postpartum hemorrhage. Health workers are expected to master effective ways to deal with postpartum hemorrhage.

MIDWIVES’ COMPLIANCE TO THE STANDARD OPERATING PROCEDURE ON THE EARLY IDENTIFICATION OF PREECLAMPSIA

Background: The main cause of maternal mortality in East Java was pregnancy hypertension (Preeclampsia/eclampsia). The percentages of pregnant women treated with early identification of preeclampsia care according to Standard Operating Procedure (SOP) in primary healthcare centers of Surabaya was still low (26%).Aim: This study aimed to analyze the factors that influence midwives’ compliance towards the SOP implementation of early identification of preeclampsia in primary healthcare centers of Surabaya.Methods: The study was an observational analytic research with cross sectional. The samples chose midwives at 20 primary healthcare centers as the informants. The independent variables are individual factors, organizational factors, and psychological factors of the midwives. The dependent variable was midwives’ compliance towards the implementation of SOP for early identification of preeclampsia.Results: The results of this study show 35% of primary healthcare centers have not implemented the SOP of early identification of Preeclampsia in pregnant women. The results also showed that the majority of primary healthcare centers in Surabaya had midwives aged 31 to 40 years (50%), graduated from a Diploma 3 education (95%), contracted status (85%) and still worked less than six years (60%).Conclusion: This research highlighted the midwives’ compliance which was determined not only by individual internal factors, but also organizational behavior. Preparing early identification of preeclampsia mechanisms, facility, and equipment proposal is important to do with the implementation of supportive system, quality control team, reward as well as punishment system. Keywords: Compliance, Early identification, Midwives, Preeclampsia, SOP.

CUIDADOS DE ENFERMERIA EN PRE-ECLAMPSIA LEVE EN EL HOSPITAL MARIO CATARINO RIVAS, I SEMESTRE, 2018


 
 
 La hipertensión arterial es un problema de salud en el mundo actual por su alta prevalencia, trascendencia e impacto en la salud, calidad de vida del ser humano, ante este evento, la mujer gestante, parturienta, puérpera y su hijo, constituyen sujetos de alta vulnerabilidad. En Honduras, las principales causas de mortalidad materna son: hemorragia (45%), trastornos hipertensivos (18%) e infecciones (12%). Este caso clínico presenta el proceso de atención de enfer- mería que se llevó a cabo sustentado en los principios que establece la teoría de Doro- thea Orem y Virginia Henderson, en donde la enfermera ayudó a la embarazada con pre eclampsia y le enseñó a cuidarse por si misma durante la estadía en el hospital. Participó una gestante de 29 años, con 33.1 semanas de gestación (SG) hospitalizada en la sala materno-fetal del Hospital Mario Catarino Rivas (HMCR) con diagnóstico de pre-eclampsia leve quien colaboró con la información necesaria para realizar las inter- venciones precisas. Dentro de los resultados más significativos se encontró que la mujer sufrió condiciones hipertensivas durante la gestación y experimentó episodios de depresión que la llevaron a mantenerse en estado de ansiedad, pues su preocupa- ción era más por la salud de su hijo y realizó todo lo que estuvo a su alcance para lograr un embarazo a término. La atención de enfermería fué fundamental para la recuperación, mantenimiento de la salud de las pacientes pues es el profesional que ejerció el rol de cuidador en las diferentes etapas de la atención.