septic abortion Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Temporal Evolution of Maternal Mortality: 1980-2019

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):662-668

    Summary

    Original Article

    Temporal Evolution of Maternal Mortality: 1980-2019

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):662-668

    DOI 10.1055/s-0041-1735300

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    Abstract

    Objective

    To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution.

    Methods

    Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327).

    Results

    After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%).

    Conclusion

    Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.

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    Temporal Evolution of Maternal Mortality: 1980-2019
  • Trabalhos Originais

    Maternal mortality at a tertiary hospital in Rio Grande do Sul – Brazil: a twenty-year study

    Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(6):431-436

    Summary

    Trabalhos Originais

    Maternal mortality at a tertiary hospital in Rio Grande do Sul – Brazil: a twenty-year study

    Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(6):431-436

    DOI 10.1590/S0100-72032003000600008

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    PURPOSE: to analyze maternal death cases that occurred at the "Hospital de Clínicas de Porto Alegre", a reference university hospital for high-risk pregnancies in the state of Rio Grande do Sul, Brazil. METHODS: we carried out a retrospective study of medical records of 10- to 49-year-old women who died at the hospital between 1980 and 1999. Deaths related to pregnancy and puerperium were analyzed independently of the kind and duration of pregnancy. The causes were classified into direct obstetric, indirect obstetric and nonobstetric, according to their association with pregnancy, delivery and puerperium disorders. RESULTS: a total of 81 patients with a mean age of 28.5 years were studied. The maternal mortality rate was 109 per 100,000 live births. Direct obstetric causes made up 61.7% of deaths. Indirect causes made up 23.5% of deaths. Nonobstetric causes made up 15.0% of the total. Among direct obstetric causes, arterial hypertension (18.5%), post-cesarean infection (16%), and septic abortion (12.3%) were the most prevalent. The main maternal mortality events among indirect obstetric causes were cardiopathy (8.6%), acute fatty liver disease (3.5%), and systemic lupus erythematosus (2.5%). Among the nonobstetric causes, malignant neoplasia (7.4%) and AIDS (3.7%) were the most important. CONCLUSIONS: the prevailing causes of maternal death have not changed in the last two decades. The main cause is still hypertension. There is an expressive number of deaths related to cesarean section and infections. The high prevalence of direct obstetric causes shows the low maternal mortality prevention capacity of our health care system.

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  • Trabalhos Originais

    Septic Abortion: Identifying Risk Factors for Complications

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(3):153-157

    Summary

    Trabalhos Originais

    Septic Abortion: Identifying Risk Factors for Complications

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(3):153-157

    DOI 10.1590/S0100-72032001000300004

    Views1

    Purpose: to evaluate the clinical and therapeutic aspects of septic abortion, and to identify a group at high risk for complications. Methods: a retrospective study of 224 cases of patients with septic abortion was conducted. Age, parity, clinical and ultrasonographic diagnosis, and therapeutic data were collected from medical charts. The information about induced abortion was provided by the patients and/or their relatives and accompanying persons. Septic abortion was diagnosed based on clinical data, leukocyte count, adnexal and uterine pain, and purulent cervical discharge. Results: the average age of patients was 21.4 ± 6.2 years. Forty-five (20.1%) patients were 19 years old or less. Sixty-six (29.5%) were primiparous and 55 (24.5%) were secundiparous. In 143 (63.8%) women it was the first abortion. The most common clinical signs were hemorrhage (83.9%) and fever (61.1%). Of the total of patients, 37.9% declared that they had an induced abortion, 33.9% declared spontaneous abortion and 28.2% did not inform. Hysterectomies were performed in five cases. No hysterectomy was performed in the group with spontaneous abortion (2.2%), which had a reduced number of complications: (3.9% versus 11.8% in the group with induced abortion), p<0.05. Conclusion: septic abortion is a more serious problem in patients who declared induced abortion.

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