Maternal hospital deaths: clinical and sociodemographic characteristics in Yucatán, México

Abstract

Objective: Describe the clinical and sociodemographic characteristics of maternal deaths that occurred in a hospital in Yucatán, Mexico, as well as propose recommendations to improve the care of pregnant women in order to help reduce in-hospital maternal mortality. Material and methods: Retrospective, cross-sectional study conducted in a second-level care concentration hospital. The hospital database of maternal deaths that occurred during the 2014–2018 period was reviewed, as well as clinical summaries, maternal death reports, maternal death ratification forms, and hospital records. Results: There were 54 maternal deaths, the year with the highest percentage was 2018 with 15 (27.8%) deaths. Most of the women resided in municipalities with low and very low degrees of marginalization 23 (42.6%); 48 (88.9%) were engaged in housework; 13 had a history of previous abortion (24.1%), with prenatal control 18 (33.3%), used some contraceptive method 13 (24.1%); and 21 (38.9%) presented some complication during pregnancy. Direct maternal deaths were mainly hypertensive disorders with 9 (32.1%) deaths. Indirect maternal deaths were mainly due to heart disease and arteriovenous disorders 6 (30.0%). The Hospital Mortality Committee issued 98 (55.1%) recommendations to improve emergency care, of which 32 (32. 6%) were related to the training of health personnel in the first level of care; and 22 (22.5%) for the second level of care. Conclusion: It is important to improve the care of the pregnant woman through the permanent training of health personnel to detect warning signs in the prenatal consultation and care of the obstetric emergency, in order to fully detect the problems that arise in the care chain of patients. Likewise, the training and updating of medical personnel for the correct completion of the basic causes of maternal death according to IDC-10 will be necessary for the correct certification of deaths.