de Rezende C H, Moreli D, de Rezende I M
Departamento de Clínica Médica, Medicina Preventiva e Comunitária, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil.
Rev Saude Publica. 2000 Aug;34(4):323-8. doi: 10.1590/s0034-89102000000400002.
The real magnitude of maternal mortality in the city of Uberlândia, Brazil, is fairly unknown. The aim is to identify the characteristics of maternal mortality in the city during 1997.
Death certificates of women between 10-49 years old from Uberlândia were used as a main data source with additional interviews with family members. Only women between 10- 49 years of age at time of death were included. Maternal deaths were further confirmed at the health services level by checking medical records and interviewing physicians. All maternal deaths occurring up to one year after delivery were investigated. Data was collected on delivery conditions, frequency of prenatal care visits, gestational age at death, previous pregnancy complications, site of death, and any avoidable conditions. Maternal mortality rates (MMR) per 100,000 newborns were calculated.
There were a total of 204 deaths, but only 173 were from Uberlândia residents. Six maternal deaths were registered, four (66.7%) up to 42 days after delivery, and two (33.3%) up to 43 days to 1 year. Direct obstetric causes (toxemia- 60%; haemorrhage- 40%) were associated with 5 deaths (83.3%), and indirect (16.7%) with 1 death (cardiac disease). The MMR calculated from death certificates was 22.2 but the adjusted rate was 66.6.
The MMR is above the expected. It is necessary to pay more attention to the quality of prenatal and delivery care as well as to the correct way of filling out death certificates.
巴西乌贝兰迪亚市孕产妇死亡率的实际严重程度鲜为人知。目的是确定1997年该市孕产妇死亡的特征。
以乌贝兰迪亚市10至49岁女性的死亡证明作为主要数据源,并对其家庭成员进行额外访谈。仅纳入死亡时年龄在10至49岁之间的女性。通过查阅病历和访谈医生,在卫生服务层面进一步确认孕产妇死亡情况。对分娩后一年内发生的所有孕产妇死亡进行调查。收集了分娩条件、产前检查就诊频率、死亡时的孕周、既往妊娠并发症、死亡地点以及任何可避免情况的数据。计算了每10万名新生儿的孕产妇死亡率(MMR)。
共有204例死亡,但只有173例是乌贝兰迪亚市居民。登记了6例孕产妇死亡,4例(66.7%)在分娩后42天内,2例(33.3%)在43天至1年之间。直接产科原因(子痫前期占60%;出血占40%)与5例死亡(83.3%)相关,间接原因(16.7%)与1例死亡(心脏病)相关。根据死亡证明计算的MMR为22.2,但调整后的比率为66.6。
MMR高于预期。有必要更加关注产前和分娩护理的质量以及死亡证明的正确填写方式。