Best Practice & Research Clinical Obstetrics & Gynaecology
3Severe acute maternal morbidity in low-income countries
Section snippets
Methods
We searched Medline and reference lists for published studies reporting on severe acute maternal morbidity. Inclusion criteria were the use of clear pre-defined conditions for a range of severe obstetric morbidities, specified dates for data collection and a clear description of methods. Search terms included maternal morbidity, obstetric morbidity, near miss, severe acute maternal morbidity, life-threatening obstetric complications, unmet obstetric needs and developing countries. We excluded
Results
A total of 37 studies from 24 countries are included in this review, and a summary of all studies is presented in Table 1. All studies, except one7, were hospital-based studies. Two further population-based studies were excluded because no clear criteria of severity were given.8, 9
Conclusions
The measurement of acute severe maternal morbidity in populations with low access to obstetric care remains challenging. There are no standard criteria for the definition of acute severe morbidity and the incidence of severe acute maternal morbidity at the population level is largely unknown. An exception to this is the incidence of life-saving surgery, for which criteria have been standardised and comparable population-based data are becoming increasingly available. Whilst the reliance on
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2017, ContraceptionCitation Excerpt :The World Health Organization (WHO) operational definitions of maternal near-miss [9] define a level of morbidity so severe that, in women with abortion-related complications, it is most likely the result of a TOP rather than a miscarriage [10], such that survival requires hospital treatment. By extension, documented near-misses at health facilities can be assumed to represent all cases within the population [11], providing an indicator of the most severe unsafe TOPs that can be tracked over time. Since it has similar characteristics, near-miss can be used as a proxy for mortality.
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