“Evaluación de los cuidados obstétricos de emergencia en relación a las complicaciones obstétricas en el hospital regional docente Ambato del 2008-2011”

Abstract

Emergency Obstetric Care (COEs) are performed in pregnant and postpartum women with complications, its purpose is to prevent maternal deaths. Establishments with COEs must provide adequate coverage for obstetric complications exceeded 15% and case fatality rate of less than 1% The Plan for Accelerated Reduction of Maternal Mortality in hospitals implemented the COEs since 2007, so this work is carried out to assess the management of direct and indirect complications in Ambato Provincial Teaching Hospital (HPDA) from 2008 to 2011.

MATERIALS AND METHODS: We performed a retrospective study documentary, reviewed the record books of Gynecology and Obstetrics, and analyze a sample of 363 randomly selected medical records. We also analyze the medical records of all maternal deaths in the indicated period. RESULTS: During the study period care coverage for obstetric complications ranged from 25 to 28% and the case fatality rate was less than 0.5%. 99% were direct obstetric complications: prolonged labor/obstructed abortion complications, hemorrhage antepartum / postpartum average of 39%, 32.3% and 18.2% respectively. There were 31 deaths: five indirect complications, 13 associated with eclampsia/severe preeclampsia, 10 obstetric sepsis (6 complications of abortion, postpartum endometritis two stillbirths and 2), there were 3 cases of hypovolemic shock (ectopic pregnancy, placental retention and uterine atony). Twenty patients died within 48 hours of hospitalization. Diagnosis was based on the average of 2 hours and treatment was initiated in 1H30. The performances surgical/drug were effective and applied according to protocols. CONCLUSIONS: The COEs for HPDA CO coverages are adequate to rising above 25% with less than 0.5% TL, with rapid and effective implementation of protocols, but constant evaluation is essential to improve the service.