Principales causas de mortalidad en gestantes ingresadas en unidades de cuidados críticos
DOI:
https://doi.org/10.35381/s.v.v9i1.4702Palabras clave:
Muerte materna, Unidad de Cuidados Obstétricos Críticos, Gestante, Complicaciones, (Fuente: DeCS).Resumen
Objetivos: Interpretar las principales causas de mortalidad en gestantes ingresadas en Unidades de Cuidados Críticos. Método: Estudio exploratorio, observacional, transversal y retrospectivo de revisión sistemática conforme a las directrices PRISMA 2020. Se incluyeron artículos científicos publicados en 2022 de las bases de datos MEDLINE, COCHRANE, SCIENCE DIRECT y SCOPUS. Resultados: De 560 artículos iniciales, se seleccionaron 27 tras revisión exhaustiva. Las principales causas de mortalidad fueron hemorragia posparto (33,3%), trastornos hipertensivos del embarazo (37,22%) y sepsis (25%). El mayor porcentaje de muertes maternas ocurre en países en vías de desarrollo. Conclusiones: Los trastornos hipertensivos, hemorragia posparto y sepsis constituyen las principales causas de muerte materna en UCI obstétricas, siendo necesario fortalecer los sistemas de salud para reducir estas cifras.
Descargas
Citas
Hernández Oliva M, Travieso Castillo Y, Díaz García J, Fernández Cabrera I. Morbilidad obstétrica en la Unidad de Cuidados Intensivos del Hospital General Docente Aleida Fernández Chardiet. Rev Habanera Cienc Méd. 2016;15(4). https://n9.cl/x4opz1
Zorrilla AD, Segovia MR. Ingresos a Unidad de Cuidados Intensivos de mujeres durante el embarazo y periodo puerperal. Rev Nac (Itauguá). 2017;49-60.
Soares FM, Pacagnella RC, Tunçalp Ö, Cecatti JG, Vogel JP, Togoobaatar G, et al. Provision of intensive care to severely ill pregnant women is associated with reduced mortality: Results from the WHO Multicountry Survey on Maternal and Newborn Health. Int J Gynaecol Obstet. 2020 Sep;150(3):346-353. https://doi.org/10.1002/ijgo.13241
Wasim T, Raana GE, Wasim M, Mushtaq J, Amin Z, Asghar S. Maternal near-miss, mortality and their correlates at a tertiary care hospital. J Pak Med Assoc. 2021 Jul;71(7):1843-1848. https://doi.org/10.47391/JPMA.05-678
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323-e333.
Baskett TF. Epidemiology of obstetric critical care. Best Pract Res Clin Obstet Gynaecol. 2008;22(5):763-774.
Di Toro F, Gjoka M, Di Lorenzo G, De Santo D, De Seta F, Maso G, et al. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clin Microbiol Infect. 2021 Jan;27(1):36-46. https://doi.org/10.1016/j.cmi.2020.10.007
WAPM (World Association of Perinatal Medicine) Working Group on COVID-19. Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection. Ultrasound Obstet Gynecol. 2021 Feb;57(2):232-241. https://doi.org/10.1002/uog.23107
Lee JH, Kwon HS, Noh YM, Shin H, Kim T, Lee TH, et al. Perinatal Outcomes According to Accessibility to Maternal-Fetal and Neonatal Intensive Care Units by Region in Korea. J Korean Med Sci. 2022 Mar 14;37(10):e77. https://doi.org/10.3346/jkms.2022.37.e77
Oncel MY, Akın IM, Kanburoglu MK, Tayman C, Coskun S, Narter F, et al. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr. 2021 Mar;180(3):733-742. https://doi.org/10.1007/s00431-020-03767-5
Ferreira DP, Amorim FF, Matsuura AJ, de Sousa JL, Santana AR, de Souza JA, et al. Pregnancy-related acute kidney injury: mortality and survival of patients treated at a maternal intensive care unit. J Nephrol. 2020 Dec;33(6):1361-1367. https://doi.org/10.1007/s40620-020-00711-6
Soares FM, Pacagnella RC, Tunçalp Ö, Cecatti JG, Vogel JP, Togoobaatar G, et al. Provision of intensive care to severely ill pregnant women is associated with reduced mortality: Results from the WHO Multicountry Survey on Maternal and Newborn Health. Int J Gynaecol Obstet. 2020 Sep;150(3):346-353. https://doi.org/10.1002/ijgo.13241
Epelboin S, Labrosse J, De Mouzon J, Fauque P, Gervoise-Boyer MJ, Levy R, et al. Obstetrical outcomes and maternal morbidities associated with COVID-19 in pregnant women in France: A national retrospective cohort study. PLoS Med. 2021 Nov 30;18(11):e1003857. https://doi.org/10.1371/journal.pmed.1003857
Prin M, Kadyaudzu C, Aagaard K, Charles A. Obstetric admissions and outcomes in an intensive care unit in Malawi. Int J Obstet Anesth. 2019 Aug;39:99-104. https://doi.org/10.1016/j.ijoa.2019.03.004
Jayaratnam S, Jacob-Rodgers S, de Costa C. Characteristics and preventability of obstetric intensive care unit admissions in Far North Queensland. Aust N Z J Obstet Gynaecol. 2020 Dec;60(6):871-876. https://doi.org/10.1111/ajo.13198
Shi H, Chen L, Wang Y, Sun M, Guo Y, Ma S, et al. Severity of Anemia During Pregnancy and Adverse Maternal and Fetal Outcomes. JAMA Netw Open. 2022 Feb 1;5(2):e2147046. https://doi.org/10.1001/jamanetworkopen.2021.47046
Saccone G, Gragnano E, Ilardi B, Marrone V, Strina I, Venturella R, et al. Maternal and perinatal complications according to maternal age: A systematic review and meta-analysis. Int J Gynaecol Obstet. 2022 Oct;159(1):43-55. https://doi.org/10.1002/ijgo.14100
Beyene T, Chojenta C, Smith R, Loxton D. Severe Maternal Outcomes and Quality of Maternal Health Care in South Ethiopia. Int J Womens Health. 2022 Feb 3;14:119-130. https://doi.org/10.2147/IJWH.S341912
Yılmaz Ergani S, Dicle İ, Aksan A, İbanoğlu MC, Tokgöz Çakır B, Kinay T, et al. Postoperative Care in the Caesarean Intensive Care Unit: Experience from a Tertiary Maternity Hospital. J Turk Ger Gynecol Assoc. 2022. https://doi.org/10.4274/jtgga.galenos.2022.2021-9-27
Lao TT. Acute respiratory distress and amniotic fluid embolism in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2022 Dec;85(Pt A):83-95. https://doi.org/10.1016/j.bpobgyn.2022.06.004
Kaskun O, Greene R. A Systematic Review of Severe Maternal Morbidity in High-Income Countries. Cureus. 2022 Oct 4;14(10):e29901. https://doi.org/10.7759/cureus.29901
Yadav A, Prakash A, Sharma C, Saha MK, Yadav S, Baghel J, et al. Maternal Mortality in the Remote Islands of India-Unraveling the Conundrum. J Family Med Prim Care. 2022 Feb;11(2):733-738. https://doi.org/10.4103/jfmpc.jfmpc_1365_21
Zhong X, Lin R, Zhang W, Huang S, Luo Y, Wang D. Epidemiology and clinical features of maternal sepsis: A retrospective study of whole pregnancy period. Medicine (Baltimore). 2022 Oct 7;101(40):e30599. https://doi.org/10.1097/MD.0000000000030599
Mashak B, Bagheri RB, Noorani G, Soleimanifakhr S, Ataei M. Comparison of Hemodynamic and Biochemical Factors and Pregnancy Complications in Women with/without Preeclampsia. Maedica (Bucur). 2022 Jun;17(2):363-370. https://doi.org/10.26574/maedica.2022.17.2.363
Mora VMG. Clasificación de morbilidad y mortalidad materna mediante una escala de disfunción orgánica [Classification of maternal morbidity and mortality using an organic dysfunction scale]. Rev Med Inst Mex Seguro Soc. 2020 Nov 4;58(6):686-697. https://doi.org/10.24875/RMIMSS.M20000102
Ayala Quintanilla BP, Pollock WE, McDonald SJ, Taft AJ. Intimate partner violence and severe acute maternal morbidity in the intensive care unit: A case-control study in Peru. Birth. 2020 Mar;47(1):29-38. https://doi.org/10.1111/birt.12461
Maged AM, Elsherief A, Hassan H, Salaheldin D, Omran KA, Almohamady M, et al. Maternal, fetal, and neonatal outcomes among different types of hypertensive disorders associating pregnancy needing intensive care management. J Matern Fetal Neonatal Med. 2020 Jan;33(2):314-321. https://doi.org/10.1080/14767058.2018.1491030
Monte AS, Teles LMR, Oriá MOB, Carvalho FHC, Brown H, Damasceno AKC. Comparison between near miss criteria in a maternal intensive care unit. Rev Esc Enferm USP. 2018 Nov 29;52:e03404. https://doi.org/10.1590/S1980-220X2017038703404
Drechsel KCE, Adu-Bonsaffoh K, Olde Loohuis KM, Srofenyoh EK, Boateng D, Browne JL; Severe Preeclampsia adverse Outcome Triage (SPOT) studies consortium. Maternal near-miss and mortality associated with hypertensive disorders of pregnancy remote from term: a multicenter observational study in Ghana. AJOG Glob Rep. 2022 Jan 12;2(2):100045. https://doi.org/10.1016/j.xagr.2021.100045
Krishna Kumar M, Joshi A, Saraswat M, Jose T, Kapoor R, Saha M, et al. Near-Miss Incidents in Obstetric Patients Admitted to an Intensive Care Unit of a Tertiary Care Center in Eastern India: A Retrospective Cohort Study. J Obstet Gynaecol India. 2022;72(Suppl 1):89-95. https://doi.org/10.1007/s13224-021-01559-x
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2025 María Valeria Macas-Tobar, Elsa Josefina Albornoz-Zamora, Miguel Eduardo Ramos-Argilagos
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
CC BY-NC-SA : Esta licencia permite a los reutilizadores distribuir, remezclar, adaptar y construir sobre el material en cualquier medio o formato solo con fines no comerciales, y solo siempre y cuando se dé la atribución al creador. Si remezcla, adapta o construye sobre el material, debe licenciar el material modificado bajo términos idénticos.
OAI-PMH: https://fundacionkoinonia.com.ve/ojs/index.php/saludyvida/oai.
