Maternal death due to obstetric hemorrhage and hypertensive disorders in Peru
Keywords:
pregnancy, obstetric hemorrhage, maternal death, childbirth, puerperium, hypertensive disordersAbstract
Introduction: Maternal mortality is a priority for health in Peru.
Objective: To analyze maternal death due to obstetric hemorrhage and hypertensive disorders in Peru.
Methods: A longitudinal and observational study was carried out in Ica, Peru, during the period 2020-2023. Of the total 562 cases of maternal mortality, there was a sample of 556 cases during pregnancy, childbirth, and the postpartum period, and 233 cases were attributed to obstetric hemorrhages and hypertensive disorders. The data were processed with the Statistical Package for Social Sciences version 25 program, where statistic were the mean, median, percentage, relative and absolute frequency.
Results: There was a minimum of 91 cases in 2023 and a maximum of 220 in 2021. The annual median was 125.5, and the mean was 141.5. A decreasing trend was observed since 2021. The distribution of maternal deaths fluctuated with a prevalence in the postpartum period: 2020 (59.3%); 2021 (58.4%); 2022 (58.5%), and 2023 (62.6%), respectively. In 2020, 27 cases were recorded due to obstetric hemorrhage (47%) and 31 due to hypertensive disorders (53%). In 2021, cases increased to 42 (53%) and 37 (47%) respectively; however, in 2022, they decreased to 29 (54%) and 25 (46%). In 2023, cases continued to decrease with a total of 42: obstetric hemorrhage (25.50%); hypertensive disorders (17.40%).
Conclusions: Although there was a trend towards a decrease in maternal death between 2021 and 2023, it is necessary to address the main causes, such as obstetric hemorrhage and hypertensive disorders.
Downloads
References
2. Aliyu LD, Kadas AS, Mohammed A, et al. Impediments to maternal mortality reduction in Africa: a systemic and socioeconomic overview. J Perinat Med. 2023;51(2):202-7. DOI: 10.1515/jpm-2022-0052.
3. Kimberley Lissette M, Huamán Santos RA, Espinoza Rojas R. Factores asociados a complicaciones post parto según la encuesta demográfica y de salud familiar en Perú 2019-2020. Rev Fac Med Humana. 2023;23(1):61-72. DOI: 10.25176/RFMH.v22i4.4772.
4. Ayala Quintanilla BP, Pollock WE, McDonald SJ, et al. Intimate partner violence and severe acute maternal morbidity in the intensive care unit: A case-control study in Peru. Birth. 2020;47(1):29-38. DOI: 10.1111/birt.12461.
5. Tarqui-Mamani C, Sanabria-Rojas H, Portugal-Benavides W, et al. Causas de muerte materna en la región de Callo, Perú. Estudio descriptivo, 2000-2015. Rev Colomb Obstet Ginecol. 2019;70(1). DOI: 10.18597/rcog.3123.
6. Vargas B, Louzado-Feliciano P, Santos N, et al. An exploration of patient-provider dynamics and childbirth experiences in rural and urban Peru: a qualitative study. BMC Pregnancy Childbirth. 2021;21(135). DOI: 10.1186/s12884-021-03586-y.
7. Tintori JA, Gomes-Sponholz FA. Epidemiology of maternal death and the challenge of professional qualification [Internet]. São José dos Pinhais: Seven Editora; 2023 [citado 03/03/2024]. Disponible en: https://sevenpublicacoes.com.br/index.php/editora/article/view/698
8. Chan SL. Translating international health policies into lived realities: Maternal health, social support programs, and obstetric violence in highland Peru. Women's Studies International Forum. 2022;92:102600. DOI: 10.1016/j.wsif.2022.102600.
9. Sejati EN, Rosa EM. Coverage of maternal health services to maternal mortality ratio moderated by public health center accreditation status and causes of maternal death. J Aisyah J Ilmu Kesehat. 2023;8(S1):195-204. DOI: 10.30604/jika.v8iS1.1697.
10. Kassa BG, Beyene FY, Demilew BC. Maternal satisfaction with emergency obstetric and newborn care services in Ethiopia and the associated factors: A systematic review and meta-analysis. Women’s Health. 2023;19. DOI: 10.1177/17455057231183854.
11. Ministerio de Salud Pública de Perú. Situación Epidemiológica de la Mortalidad Materna en el Perú, 2022-2023 (SE 18) [Internet]. Lima: Ministerio de Salud Pública; 2023 [citado 28/03/2024]. Disponible en: https://www.mesadeconcertacion.org.pe/storage/documentos/2023-05-18/cdc-mortalidad-materna-2022-2023.pdf
12. Einspieler C, Prayer D, Marschik PB. Fetal movements: the origin of human behaviour. Dev Med Child Neurol. 2021;63(10):1142-8. DOI: 10.1111/dmcn.14918.
13. Gutiérrez Ramos M. Mortalidad materna, ¿cambiando la causalidad el 2021? Rev Peru Ginecol Obstet. 2022;68(1). DOI: 10.31403/rpgo.v68i2407.
14. Maza-Arnedo F, Paternina A, Sosa CG, et al. Maternal mortality linked to COVID-19 in Latin America: Results from a multi-country collaborative database of 447 deaths. The Lancet. 2022;12(100269). DOI: 10.2139/ssrn.4035411.
15. Tiwari C, Jain N, Goli S, et al. Political determinants of health: (re) examining the role of governance in reducing maternal mortality. Health Econ Policy Law. 2023;18(3):248-73. DOI: 10.1017/S1744133123000026.
16. Fondo de Población de las Naciones Unidas. Muertes maternas aumentarán en 40 % debido a la pandemia si no se recupera el sistema de salud [Internet]. Nueva York: Fondo de Población de las Naciones Unidas; 2020 [citado 07/01/2023]. Disponible en: https://peru.unfpa.org/es/news/muertes-maternas-aumentar%C3%A1n-en-40-debido-la-pandemia-si-no-se-recupera-el-sistema-de-salud
17. Gardiner E, Lai JF, Khanna D, et al. Exploring women’s decisions of where to give birth in the Peruvian Amazon; why do women continue to give birth at home? A qualitative study. PLoS One. 2021;16(9):e0257135. DOI: 10.1371/journal.pone.0257135.
18. Del Mastro NI, Tejada-Llacsa PJ, Reinders S, et al. Home birth preference, childbirth, and newborn care practices in rural Peruvian Amazon. PLoS One. 2021;16(5):e0250702. DOI: 10.1371/journal.pone.0250702.
19. Liñan-Bermúdez A, León Pastuso P, Chafloque Chavesta JJ, et al. Control del puerperio en mujeres peruanas de zona urbana y rural: análisis secundario de una encuesta nacional. Rev Obstet Ginecol Venez. 2022;82(2):206-12. DOI: 10.51288/00820210.
20. Rougeaux E, Miranda JJ, Fewtrell M, et al. Maternal internal migration and child growth and nutritional health in Peru: an analysis of the demographic and health surveys from 1991 to 2017. BMC Public Health. 2022;22(1). DOI: 10.1186/s12889-021-12452-7.
21. Holman C, Glover A, Fertaly K, et al. Operationalizing risk-appropriate perinatal care in a rural US State: directions for policy and practice. BMC Health Serv Res. 2023;23(601). DOI: 10.1186/s12913-023-09552-y.
22. Sharma AK, Rastogi R, Bamaniya A, et al. Using the new ICD-MM classification system for attributionof cause of maternal death: a retrospective study from atertiary care hospital of Rajasthan. Int J Reprod Contracept Obstet Gynecol. 2022;11(9). DOI: 10.18203/2320-1770.ijrcog20222311.
23. Salinas Cordero KC. Mortalidad materna en el Perú: Impacto en el contexto covid 19 en el periodo 2020-2022. Revista de Climatología. 2023;23:481-92. DOI: 10.59427/rcli/2023/v23cs.481-492.
24. Dobrovolska LM, Likhachov VK, Vaschenko VL, et al. Innovative approaches to prevention of obstetric hemorrhage during abdominal delivery in women with placentation abnormalities and hypertensive disorders. Actual Problems of the Modern Medicine: Bulletin of Ukrainian Medical Stomatological Academy [Internet]. 2022 [citado 07/01/2023];22(3-4):4-7. Disponible en: https://ouci.dntb.gov.ua/en/works/4E68Vg0l/
25. Khoso S, Soomro A, Hashmi S, et al. A retrospective case-control study on the risk factors of postpartum hemorrhage. Pakistan Journal of Medical and Health Science. 2022;16(8):742-4. DOI: 10.53350/pjmhs22168742.
Downloads
Published
How to Cite
Issue
Section
License
All content published in this journal is Open Access, distributed under the terms of the CC BY-NC 4.0 License.
It allows:
- Copy and redistribute published material in any medium or format.
- Adapt the content.
This will be done under the following terms:
- Attribute the authors' credits and indicate whether changes were made, in which case it must be in a reasonable way.
- Non-commercial use.
- Recognize the journal where it is published.
The copyrights of each article are maintained, without restrictions.
Guidelines to authors
