Extreme maternal morbidity (EMM): description of a 23-case series and analysis of the “three delays”

Abstract

Extreme maternal morbidity is a public health problem that has been the focus of institutions, agencies and governments all over the world due to its high frequency and impact. Despite efforts made, established goals have not been reached. Objective. To characterize delays in health care in patients with EMM as determining factors in the occurrence of these events. Methods. A descriptive case series study with pregnant women suffering from EMM during March, 2013 at a University Hospital. Results. There were 23 cases of women suffering from MME, 65.2% under 25 years of age. Most of them lived in urban areas (65.2%), had a stable relationship (65.22%) and had social security (86.96%). A 1.1 ratio was found regarding wanted gestation against unwanted, 75% of patients who did not want their pregnancy, did not use any contraceptive method. None of the patients attended preconceptional medical consultation, half of them had adherence to prenatal program and just 65.2% had early uptake. It was mainly identified type-one delays (69.6%) and type three (65.2%). In 8 (34.78%) out of 23 cases there was some kind of adverse event; from these, 50% (four cases) were classified as mild and moderate and the remaining 50% was severe.