Characterization of surgical treatment used in patients with extreme maternal morbidity
Keywords:
Morbilidad, Puerperio, Complicaciones, Cesárea, Histerectomía, Tratamiento.Abstract
Introduction: for many women, pregnancy and childbirth constitute positive experiences, but if they are exposed to risk factors that lead to damage to the health of the mother-fetus pair and are not addressed quickly and effectively, maternal death is possible. Objective: to characterize the surgical treatment used in patients with extreme maternal morbidity. Method: an observational, descriptive, cross-sectional and retrospective study was carried out on the surgical treatment of patients with extreme maternal morbidity between the years 2018 and 2020 at the Fe del Valle Ramos Hospital in Manzanillo, Granma. This group included 70 patients who required admission to the intensive care unit for emergency surgical treatment. Due to the need for the study, 100 % of the patients were studied. Results: due to fetal risk, 20 % of patients required cesarean section and the majority of cesarean sections were classified as contaminated (37,1 %) based on postoperative classification. Puerperal endometritis was the most common event (47,1 %) and was treated with definitive surgical treatment, with obstetric hysterectomy being the most common (71,7 %). Conclusions: in patients with extreme maternal morbidity, the risk of loss of fetal well-being is the main indication for cesarean section. Puerperal endometritis and obstetric hemorrhage are the main causes of this affections. Hysterectomy is the procedure of choice to treat complications associated with this.
Downloads
References
1. Vera Loyola E, Villar Chamorro A, Ramirez Cabrera J, Csetovic A, Cruzate Cabrejos V, Porterico JA, Jaramillo-Valverde L, Guio H, et al. Factores de riesgo asociados a la morbilidad materna extrema. Rev Cubana Med Milit [Internet]. 2024 [citado 4 Oct 2024]; 53 (3). Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/21454
2. Manual para la Vigilancia Epidemiológica de Muertes Maternas; Dirección General de Epidemiología; [Internet]. 2020. [citado 4 Oct 2024]; Disponible en: https://epidemiologia.salud.gob.mx/gobmx/salud/documentos/manuales/15_Manual_Muertes_Maternas_Lineamientos.pdf
3. Quintana González J Ángel, Fernández Pacheco Riverón VR, Quintana del Junco A. Caracterización de la morbilidad materna extrema en una unidad de cuidados intensivos. Mediciego [Internet]. 2024 [citado 4 Oct 2024]; 30:e3701. Disponible en: https://revmediciego.sld.cu/index.php/mediciego/article/view/3701
4. Hoyos Vertel LM, Muñoz de Rodríguez L. Barreras de acceso a controles prenatales en mujeres con morbilidad materna extrema en Antioquia, Colombia. Rev. Salud Pública. 2019. 21 (1): 17-21, 2019. DOI: https://doi.org/10.15446/rsap.V21n1.69642
5. Guevara Ríos E. Morbilidad materna extrema en el Instituto Nacional Materno Perinatal del Perú, experiencia y resultados. Rev peru ginecol obstet. [Internet]. 2024 [citado 6 Oct 2024];70(2). Disponible en: http://51.222.106.123/index.php/RPGO/article/view/2627
6. Nava Guerrero EN, Nungaray González L , Salcedo González A, Cisneros Rivera F, Perales Dávila J, Durán Luna A. Rev Ginecol Obstet Mex. [Internet]. 2020 [citado 6 Oct 2024]; 88 (9): 606-614. DOI: http://dx.doi.org/10.24245/gom.v88i9.4246
7. Gámez Gámez LN, Díaz Jiménez MM, Gámez Borges LN. Morbilidad materna en el servicio de Obstetricia del Hospital General Docente “Dr. Agostinho Neto”. Rev Inf Cient [Internet]. 2021 [citado 6 Oct 2024]; 100(3):e3352. Disponible en: http://www.revinfcientifica.sld.cu/index.php/ric/article/view/3352
8. Hernández Cabrera Y, León Ornelas M, Díaz Puebla J, Ocampo Sánchez A, Rodríguez Márquez A, Ruiz-Hernández M. Caracterización clínica de pacientes con morbilidad materna extremadamente grave y su repercusión perinatal. Cienfuegos 2016-2018. Medisur [Internet]. 2020 [citado 6 Oct 2024]; 18(5):[aprox. 10 p.]. Disponible en: https://medisur.sld.cu/index.php/medisur/article/view/4440
9. Yace Martinez J, Bravo Heredia A, Mucha Chuquirachi O. Caracterización de la morbilidad materna extrema en mujeres atendidas en el Hospital de Emergencias Villa el Salvador, durante el año 2019. Rev Int de Salud Materno Fetal. 2020;5 (4): 21-30. DOI: https://doi.org/10.47784/rismf.2020.5.4.98
10. Hernández Núñez J, Au Fonseca O. Morbilidad materna extrema y mortalidad en un hospital regional de Sudáfrica. Rev. chil. obstet. Ginecol. 2019 84(6): 469-479. DOI: http://dx.doi.org/10.4067/S0717-75262019000600469
11. Ferrer Fernández A, Millán Vega M, Rosales Boza Y, López Céspedes Y. Morbilidad materna grave en la provincia Granma. 2018. MULTIMED [Internet]. 2020 [citado 6 Oct 2024]; 24 (2) Disponible en: https://revmultimed.sld.cu/index.php/mtm/article/view/1918
12. Ministerio de Salud Pública. Dirección Nacional de Estadísticas. Anuario Estadístico de Salud 2021 [Internet]. La Habana: MINSAP; 2022. [citado 6 Oct 2024]. Disponible en: https://files.sld.cu/bvscuba/files/2021/08/Anuario-Estadistico-Espa%C3%B1ol-2020-Definitivo.pdf
13. Fong Pantoja L. Morbilidad materna en Unidad de Cuidados Intensivos del Hospital General Docente “Orlando Pantoja Tamayo”, Santiago de Cuba 2014-2019. Rev inf cient [Internet]. 2020 [citado 8 Oct 2024]; 99(1):00-00. Disponible en: http://www.revinfcientifica.sld.cu/index.php/ric/article/view/2737
14. Nápoles Méndez D. Principales resultados en el Programa de Atención Materno-Infantil durante el 2017 y nuevas estrategias en Cuba para el 2018. MEDISAN [Internet]. 2018 [citado 11 Oct 2024]; 22(2):217-2018. Disponible en: http://scielo.sld.cu/pdf/san/v22n2/san15222.pdf
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Yunior Meriño Pompa, Sulanys Yainet Naranjo Vázquez, Mirtha Johnson Quiñones

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who have publications with this journal agree to the following terms: authors retain their copyright and grant the journal the right of first publication of their work, which is simultaneously subject to the Creative Commons Attribution-NonCommercial 4.0 International License that allows third parties to share the work as long as the author and first publication in this journal are indicated, for non-commercial use. Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g., depositing it in an institutional telematic archive or publishing it in a monographic volume) as long as the initial publication in this journal is indicated. Authors are allowed and encouraged to disseminate their work via the Internet (e.g., in institutional telematic archives, in their web page or in Pre-print servers) before and during the submission process, which can lead to interesting exchanges and increase citations of the published work. (See The Open Access Effect).