Causes of maternal mortality in the Instituto Mexicano del Seguro Social, period 2009-2012
Main Article Content
Keywords
Maternal mortality, Cause of death, Hospital death
Abstract
Background: The maternal mortality ratio (MMR) has declined slowly, despite the WHO resolved to reduce up to 75 % the maternal mortality from 1990 to 2015. This is why it is necessary to continue the analysis of the causes to strengthen and innovate the courses of action to reduce maternal deaths in our country.
Methods: A retrospective study which included maternal deaths (due to direct and indirect causes) that occurred in the period 2009-2012. The information was obtained from the file of maternal death, which is an Instituto Mexicano del Seguro Social (IMSS) official source. We used the WHO definition of maternal death. Indirect deaths were grouped according to the International Classification of Illnesses (ICI-10). It was used descriptive statistics.
Results: The MMR in the IMSS has declined slowly but steadily: in 2012, it was recorded the lowest MMR in this institute: 26.4. However, severe preeclampsia-eclampsia and obstetric hemorrhage were the first and second place, respectively, as direct causes of death. As indirect causes, cardiovascular diseases and malignant neoplasms were the first places (without underestimating the respiratory diseases top figures).
Conclusions: It is necessary to keep doing our efforts to diminish maternal deaths in all levels of medical care at the IMSS. It is a priority to continue education and preconception counseling to women of childbearing age with such diseases.
References
United Nations Millennium Declaration. Fifty-fifth 45 Session of the United Nations General Assembly. New York: United Nations; Sep 18, 2000.
World Health Organization. Trends in maternal mortality: 1990 to 2008. [Internet]. Geneve: WHO; 2010. Disponible en www.who.int/reproductive-health.
Lozano R, Wang H, Foreman KJ, Rajaratnam JK, Naghavi R, Marcus JR, et al. Progress Towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet. 2011; 378(9797):1139-65.
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet. 2010;375(9726):1609-23.
Danel I, Graham WJ, Boerma T. Maternal death surveillance and response. Bull World Health Organ. 2011; 89(11):779.779A.
Gilmore K, Gebreyesus TA. What will it take to eliminate preventable maternal deaths? Lancet. 2012;380(9837):87-8.
Hounton S, De Bernis L, Hussein J, Graham WJ, Danel I, Byass P, et al. Towards elimination of maternal deaths: maternal deaths surveillance and response. Reprod Health. 2013,10:1. Texto Libre en http://www.reproductive-health journal.com/content/10/1/1
Wise J. Maternal mortality is a human rights issue, delegates insist. BMJ. 2007; 335(7625):845.
Organization for Economic Co-Operation and Development (OECD). Stat Extracts. Mortality .[Internet]. France: OECD; 2013. Disponible en http://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_STAT#
Clark SL. Strategies for reducing maternal mortality. Semin Perinatol. 2012; 36(1):42-7.
Hu D, Bertozzi SM, Gakidou E, Sweet S, Goodie SJ. The costs, benefits, and cost-effectiveness of interventions to reduce maternal morbidity and mortality in Mexico. PLoS One. 2007; 2(8):e750. doi: 10.1371/journal.pone.0000750. Texto libre en http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1939734/
World Health Organization. Trends in maternal mortality: 1990 to 2008. Estimates developed by and The World Bank. Geneva: WHO/UNICEF/UNFPA; 2010. Texto libre en http://whqlibdoc.who.int/publications/2010/9789241500265_eng.pdf
World Health Organization. International Statistical Classification of Diseases and Related Health Problems. Tenth Revision. Vol. 1: Tabular list. Vol. 2: Instruction manual. Geneva: WHO; 1992.
Consejo Nacional de Población. La Situación Demográfica de México 2011 [Internet]. México: CONAPO; 2011. Capítulo, Mendoza VD, Hernández LF, Valencia RJ. Perfil de la salud reproductiva de la República Mexicana. Disponible en http://www.conapo.gob.mx/es/CONAPO/Perfil_de_la_salud_reproductiva_de_la_Republica_Mexicana
Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. Who analysis of causes of maternal death: a systemic review. Lancet. 367(9516):1066-74.
Clark SL, Hankins GD. Preventing maternal death: 10 clinical diamonds. Obstet Gynecol. 2012; 119(2 Pt 1):360-4.
World Health Organization. Global health risks: mortality and burden of disease attributable to selected major risks. Geneve: World Health Organization; 2009. Texto Libre en http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf
Freyermuth EMG. Características sociodemográficas que obstaculizan el acceso efectivo a instituciones de salud por parte de mujeres embarazadas en 2010. México: Consejo Nacional de Evaluación de la Política de Desarrollo Social. Centro de Investigaciones y Estudios Superiores en Antropología Social (CIESAS); 2012.
Ghulmiyyah L, Sibai B. Maternal mortality from preeclampsia/eclampsia. Semin Perinatol. 2012; 36(1):56-9.
Knight M, Callaghan WM, Berg C, Alexander S, Bouvier-Colle MH, Ford JB, et al. Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group. BMC Pregnancy Childbirth. 2009; 9:55. Texto Libre en http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790440/
Haeri S, Dildy GA 3rd. Maternal mortality from hemorrhage. Semin Perinatol. 2012; 36(1):48-55.
Vélez-Álvarez GA, Agudelio-Jaramillo B, Gómez-Dávila JG. Zuleta-Tobón JJ. Código Rojo: Guía para el manejo de la hemorragia obstétrica. Revista Colombiana Obstetricia y Ginecología. 2009; 60(1):34-48.
Ruiz-Rosas AR, Cruz-Cruz PR, Torres-Arreola LP. Hemorragia obstétrica, causa de muerte materna. IMSS, 2011. Rev Med Inst Mex Seguro Soc [Internet]. 2012; 50(6):659-64. Texto libre en http://revistamedica.imss.gob.mx/index.php?option=com_multicategories&view=article&id=1994:hemorragia-obs
tetrica&catid=758:practica-clinico-quirurgica&Itemid
=766
Bello-Carrera R, Romero-López Z, Ochoa-Vázquez MD, Reyes-Calderon H, Rico-Méndez FG. Infección por virus influenza A H1N1 en pacientes embarazadas. Rev Med Inst Mex Seguro Soc. 2010;48(4):399-404. Texto libre http://revistamedica.imss.gob.mx/index.php?option=com_multicategories&view=category&layout=blog&id=143&Itemid=605&limitstart=6
World Health Organization. Countdown to 2015 decade report (2000-10): taking stock of maternal, newborn and child survival. [Internet] Geneve: WHO/UNICEF;2010. Texto Libre http://www.childinfo.org/files/CountdownReport_2000-2010.pdf
Paxton A, Maine D, Freedman L, Fry D, Lobis S. The evidence for emergency obstetric care. Int J Gynecol Obstet. 2005;88(2):181-93.
Souza JP, Gülmezoglu AM, Vogel J, Carroli G, Lumbiganon P, Qureshi Z, et al. Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health): a cross-sectional study. Lancet. 2013; 381(9879): 1747-55.