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  • Trabalhos Originais

    Maternal mortality in São Paulo City from 1993 to 1995

    Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(1):13-18

    Summary

    Trabalhos Originais

    Maternal mortality in São Paulo City from 1993 to 1995

    Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(1):13-18

    DOI 10.1590/S0100-72031998000100003

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    The parpose of the present report was to determine the maternal mortality rate in São Paulo, the most frequent pathologies which caused death and the distribution of cases paccording to age. In thepresent retrospective study 179,872 death certificates from April 1993 to December 1995 of women from 10 to 49 years old. Were reviewed 761 death certificates were selected, in which the pregnancy state was either declared or presumed; pregnancy was confirmed in 291/761 cases and 53/761 cases are still under investigation. The data were tabulated, grouped and analyzed considering the age and cause of death, according to the 9th revised edition of ICD - International Classification of Diseases. Of the 291 positive cases, 82 (28.17%) did not show any reference to the pregnancy state in the death certificate (undernotification); 183/291 cases (62.89%) were direct maternal deaths and the main diseases leading to maternal death were: hemorrhage (47/183), preeclampsia-eclampsia (46/183) and abortion complications (43/183). Among the indirectly related causes of maternal death (79/291), cardiopaty was the most frequent (33/79). Hypertensive syndrome (preeclampsia-eclampsia and/or chronic arterial hypertension) were responsible for 58/291 cases (19.93%) of maternal deaths. This study allowed us to calculate the maternal mortality rate for São Paulo: 50.24:100,000 live births.

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  • Trabalhos Originais

    Maternal Mortality in São Paulo City in 1996

    Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):395-403

    Summary

    Trabalhos Originais

    Maternal Mortality in São Paulo City in 1996

    Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):395-403

    DOI 10.1590/S0100-72031998000700005

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    Purpose: to establish a list of diseases promoting maternal death according to frequency. Methods: In 1996, 65,406 deaths were recorded in the City of São Paulo, 26,778 of which were of women. Of these, 4591 were within the 10-49 year age bracket. We analyzed the latter group, regarding at the field "Cause of Death" in the Death Certificate, trying to establish some correlation between the described pathology, and the pregnancy-puerperium cycle. We separated for a further study 293 Death Certificates, from which we selected, after hospital survey and/or home visits, a total of 119 positive cases for maternal death. The positive cases for maternal death were then tabulated, grouped and analyzed according to age and pathology, using the great medical care groups. Results: as regards the 119 positive cases for maternal death, we did not find any reference to the pregnancy-puerperium state in 53 of them (that is, 40.54% subnotifying). The cases were grouped according to pathology, where we found a predominance of eclampsia/pre-eclampsia cases (18.02%), followed by cases resulting from hemorrhagic complications in the third quarter and puerperium (12.61%), abortion complications (12.61%), puerperal infection (9.91%) and cardiopathies (9.91%). Conclusions: for the first time, we are publishing the Late Maternal Mortality Coefficient for the City of São Paulo, which was 51.33/100,000 born alive. However, we used for the official publication the Maternal Mortality Coefficient for death within up to 42 days of puerperium, which was, 48.03/100,000 born alive for the city of São Paulo. We should bear in mind that no correction factor should be applied to these figures since we have made an active search of cases.

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  • Revisão

    Beneficial interventions for maternal mortality prevention in the prenatal period

    Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):310-315

    Summary

    Revisão

    Beneficial interventions for maternal mortality prevention in the prenatal period

    Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):310-315

    DOI 10.1590/S0100-72032006000500008

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    Maternal mortality rate (MM) is a health quality indicator that is directly influenced by the economic, cultural and technological level of a country. Official data of MM in Brazil, although underestimated, point to the lack of quality in pregnancy, childbirth and puerperium care services. This characteristic is common in developing countries, where poorer pregnant women as well as those facing greater difficulty to quality care access are found. Prenatal care cannot prevent major childbirth complications, which are important causes of MM; however, some interventions during the prenatal period can favor maternal prognosis and prevent MM. In this setting, this study brings a scientifically based update concerning effective interventions for maternal mortality prevention during the prenatal period. The most important strategies consist of a tripod with specific interventions related to maternal health promotion, risk prevention and assurance of nutritional support during gestation, in addition to criteria to investigate gestational risk and inclusion of the pregnant woman in the basic component of the prenatal care model. It ends with the definition of priorities in the prevention of MM related to eclampsia/preeclampsia and reinforces the importance of normalization of reference systems for obstetric emergency cases.

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    Beneficial interventions for maternal mortality prevention in the prenatal period
  • Resumos de Teses

    Maternal mortality in the city of Sao Paulo, from 1995 to 1999, with emphasis on hypertension

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):672-672

    Summary

    Resumos de Teses

    Maternal mortality in the city of Sao Paulo, from 1995 to 1999, with emphasis on hypertension

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):672-672

    DOI 10.1590/S0100-72032004000800014

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