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Severe acute maternal morbidity and mortality in the Pretoria Academic Complex: changing patterns over 4 years
Hilde I B Vandecruys1, Robert C Pattinson, A P Macdonald
1MRC Research Unit for Maternal and Infant Health Care Strategies, Department of Obstetrics and Gynecology, Kalafong Academic Hospital, University of Pretoria, Pretoria 0001, South Africa.
Objective:
To compare the severe acute maternal morbidity (SAMM) and maternal mortality in the Pretoria Academic Complex for the year 2000 and the years 1997-1999.
Study Design:
SAMM and maternal mortality was identified at daily audit meetings. The audit was performed from 1 January 2000 to 31 December 2000 and compared with the data obtained from the original 2-year audit [Br J Obstet Gynecol 105 (1998) 985]. The mortality index (MI) was defined as Maternal Death (MD) divided by SAMM and MD. This index is used to assess the standard of care in specific maternal conditions. Data was assessed using the Chi square test.
Results:
SAMM and maternal mortality has significantly declined in all patients with a reduction in abortion complications as the main contributor (268/100,000 births versus 94/100,000 births P<0.006). There is a non-significant trend to increased morbidity and mortality in hypertension, hemorrhage and infections.
Conclusions:
The standard of care was constant. An audit of SAMM and maternal mortality allows for early detection of trends and early changes in health strategies.