All maternal deaths related to placenta accreta spectrum are preventable: a difficult-to-tell realityAJOG Global Reports at a Glance
BACKGROUND: Most maternal deaths related to postpartum hemorrhage are preventable. In most cases, placenta accreta spectrum is the principal cause of severe postpartum hemorrhage; however, there are few studies about maternal deaths, probably because of the legal implications of “problems” in the ma...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-08-01
|
| Series: | AJOG Global Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666577821000101 |
| _version_ | 1819148702679302144 |
|---|---|
| author | Albaro J. Nieto-Calvache, MD José M. Palacios-Jaraquemada, MD Lina M. Vergara-Galliadi, MD Lía Matera, MD José E. Sanín-Blair, MD Eliana P. Rivera, MD Adda P. Rozo-Rangel, MD Juan M. Burgos-Luna, MD |
| author_facet | Albaro J. Nieto-Calvache, MD José M. Palacios-Jaraquemada, MD Lina M. Vergara-Galliadi, MD Lía Matera, MD José E. Sanín-Blair, MD Eliana P. Rivera, MD Adda P. Rozo-Rangel, MD Juan M. Burgos-Luna, MD |
| author_sort | Albaro J. Nieto-Calvache, MD |
| collection | DOAJ |
| description | BACKGROUND: Most maternal deaths related to postpartum hemorrhage are preventable. In most cases, placenta accreta spectrum is the principal cause of severe postpartum hemorrhage; however, there are few studies about maternal deaths, probably because of the legal implications of “problems” in the management of patients who have died. OBJECTIVE: This study aimed to identify the problems or “delays” in the care of patients who die because of placenta accreta spectrum in Latin America. STUDY DESIGN: A retrospective, descriptive, observational multicentric study in Latin American hospitals was conducted. The care of patients who died from placenta accreta spectrum was investigated under a “delay” study model that included delays related to patients, institutions, and healthcare providers. Centers of excellence standards of care were taken into account, and 2 analysis moments were included: an initial analysis for each local care group in the place where maternal death occurred and another analysis that included the main researcher. All information were collected through a predesigned survey and discussed by telephone. RESULTS: Overall, 52 patients in 10 Latin American countries were included, with options for improvement identified in all cases. The most prevalent type of delay was associated with health providers (98% of cases), followed by health institutions (96% of cases) and patients (63% of cases). Each hospital's analysis group defined maternal death as avoidable in all cases and determined that the interventions needed to improve the outcome would present low, moderate, and high difficulties in 28.8%, 48.1%, and 34.8% of cases, respectively. CONCLUSION: All maternal deaths related to placenta accreta spectrum were potentially preventable, and 76.9% of cases were avoidable by low to moderate complexity interventions. |
| first_indexed | 2024-12-22T13:49:55Z |
| format | Article |
| id | doaj.art-b2ec5e5467b54990b63ddad012093b2c |
| institution | Directory Open Access Journal |
| issn | 2666-5778 |
| language | English |
| last_indexed | 2024-12-22T13:49:55Z |
| publishDate | 2021-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | AJOG Global Reports |
| spelling | doaj.art-b2ec5e5467b54990b63ddad012093b2c2022-12-21T18:23:41ZengElsevierAJOG Global Reports2666-57782021-08-0113100012All maternal deaths related to placenta accreta spectrum are preventable: a difficult-to-tell realityAJOG Global Reports at a GlanceAlbaro J. Nieto-Calvache, MD0José M. Palacios-Jaraquemada, MD1Lina M. Vergara-Galliadi, MD2Lía Matera, MD3José E. Sanín-Blair, MD4Eliana P. Rivera, MD5Adda P. Rozo-Rangel, MD6Juan M. Burgos-Luna, MD7Clinica de Espectro de Acretismo Placentario, Fundación Valle del Lili, Cali, Colombia (Drs AJ Nieto-Calvache and Burgos-Luna); Corresponding author: Albaro J. Nieto-Calvache, MD.Hospital Universitario CEMIC, Buenos Aires, Argentina (Dr Palacios-Jaraquemada)Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia (Dr Vergara-Galliadi)Placenta Accreta Spectrum Team, Clínica Santa Cruz de Bocagrande, Cartagena, Colombia (Dr Matera)Maternal Fetal Medicine Unit, Clinica Universitaria Bolivariana/Clinica el Rosario, Medellín, Colombia (Dr Sanín-Blair)Clinica Laura Daniela, Valledupar, Colombia (Dr Rivera)Hospital San José, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia (Dr Rozo-Rangel)Clinica de Espectro de Acretismo Placentario, Fundación Valle del Lili, Cali, Colombia (Drs AJ Nieto-Calvache and Burgos-Luna)BACKGROUND: Most maternal deaths related to postpartum hemorrhage are preventable. In most cases, placenta accreta spectrum is the principal cause of severe postpartum hemorrhage; however, there are few studies about maternal deaths, probably because of the legal implications of “problems” in the management of patients who have died. OBJECTIVE: This study aimed to identify the problems or “delays” in the care of patients who die because of placenta accreta spectrum in Latin America. STUDY DESIGN: A retrospective, descriptive, observational multicentric study in Latin American hospitals was conducted. The care of patients who died from placenta accreta spectrum was investigated under a “delay” study model that included delays related to patients, institutions, and healthcare providers. Centers of excellence standards of care were taken into account, and 2 analysis moments were included: an initial analysis for each local care group in the place where maternal death occurred and another analysis that included the main researcher. All information were collected through a predesigned survey and discussed by telephone. RESULTS: Overall, 52 patients in 10 Latin American countries were included, with options for improvement identified in all cases. The most prevalent type of delay was associated with health providers (98% of cases), followed by health institutions (96% of cases) and patients (63% of cases). Each hospital's analysis group defined maternal death as avoidable in all cases and determined that the interventions needed to improve the outcome would present low, moderate, and high difficulties in 28.8%, 48.1%, and 34.8% of cases, respectively. CONCLUSION: All maternal deaths related to placenta accreta spectrum were potentially preventable, and 76.9% of cases were avoidable by low to moderate complexity interventions.http://www.sciencedirect.com/science/article/pii/S2666577821000101health policymaternal mortalityplacenta accretaquality of healthcare |
| spellingShingle | Albaro J. Nieto-Calvache, MD José M. Palacios-Jaraquemada, MD Lina M. Vergara-Galliadi, MD Lía Matera, MD José E. Sanín-Blair, MD Eliana P. Rivera, MD Adda P. Rozo-Rangel, MD Juan M. Burgos-Luna, MD All maternal deaths related to placenta accreta spectrum are preventable: a difficult-to-tell realityAJOG Global Reports at a Glance AJOG Global Reports health policy maternal mortality placenta accreta quality of healthcare |
| title | All maternal deaths related to placenta accreta spectrum are preventable: a difficult-to-tell realityAJOG Global Reports at a Glance |
| title_full | All maternal deaths related to placenta accreta spectrum are preventable: a difficult-to-tell realityAJOG Global Reports at a Glance |
| title_fullStr | All maternal deaths related to placenta accreta spectrum are preventable: a difficult-to-tell realityAJOG Global Reports at a Glance |
| title_full_unstemmed | All maternal deaths related to placenta accreta spectrum are preventable: a difficult-to-tell realityAJOG Global Reports at a Glance |
| title_short | All maternal deaths related to placenta accreta spectrum are preventable: a difficult-to-tell realityAJOG Global Reports at a Glance |
| title_sort | all maternal deaths related to placenta accreta spectrum are preventable a difficult to tell realityajog global reports at a glance |
| topic | health policy maternal mortality placenta accreta quality of healthcare |
| url | http://www.sciencedirect.com/science/article/pii/S2666577821000101 |
| work_keys_str_mv | AT albarojnietocalvachemd allmaternaldeathsrelatedtoplacentaaccretaspectrumarepreventableadifficulttotellrealityajogglobalreportsataglance AT josempalaciosjaraquemadamd allmaternaldeathsrelatedtoplacentaaccretaspectrumarepreventableadifficulttotellrealityajogglobalreportsataglance AT linamvergaragalliadimd allmaternaldeathsrelatedtoplacentaaccretaspectrumarepreventableadifficulttotellrealityajogglobalreportsataglance AT liamateramd allmaternaldeathsrelatedtoplacentaaccretaspectrumarepreventableadifficulttotellrealityajogglobalreportsataglance AT joseesaninblairmd allmaternaldeathsrelatedtoplacentaaccretaspectrumarepreventableadifficulttotellrealityajogglobalreportsataglance AT elianapriveramd allmaternaldeathsrelatedtoplacentaaccretaspectrumarepreventableadifficulttotellrealityajogglobalreportsataglance AT addaprozorangelmd allmaternaldeathsrelatedtoplacentaaccretaspectrumarepreventableadifficulttotellrealityajogglobalreportsataglance AT juanmburgoslunamd allmaternaldeathsrelatedtoplacentaaccretaspectrumarepreventableadifficulttotellrealityajogglobalreportsataglance |