Article
Severe acute obstetric morbidity (near-miss): a review of the relative use of its diagnostic indicators
Registro en:
REICHENHEIM, Michael E. et al. Severe acute obstetric morbidity (near-miss): a review of the relative use of its diagnostic indicators. Archives of Gynecology and Obstetrics, Munchen, v. 280, p. 337–343, 2009.
0932-0067
10.1007/s00404-008-0891-1
Autor
Reichenheim, Michael Eduardo
Zylbersztajn, Flávio
Moraes, Claudia L.
Lobato, Gustavo
Resumen
Objective To assess the most commonly employed diag-nostic indicators of severe maternal morbidity (obstetric near-miss). Methods Review of the literature from January 1989 to August 2008. Results Fifty-one manuscripts met the eligibility criteria, and 96 indicators were utilized at least once. Admission to intensive care unit (n= 28 studies) was the indicator most frequently utilized, followed by eclampsia and hemorrhage (n= 27), blood transfusion (n= 26) and emergent hysterec-tomy (n=24). Conclusion Considering these Wndings, a trial version of a 13-item instrument for diagnosing obstetric near-miss is proposed. It includes the indicators eclampsia, severe hypertension, pulmonary edema, cardiac arrest, obstetrical hemorrhage, uterine rupture, admission to intensive care unit, emergent hysterectomy, blood transfusion, anesthetic accidents, urea >15 mmol/l or creatinine >400 mmol/l, oli-guria (<400 ml/24 h) and coma. Further studies should focus on consensual deWnitions for these indicators and evaluate the psychometric proprieties of this trial version.