Maternal morbidity and mortality in Slovak Republic in the years 2007–2015


Authors: M. Korbeľ 1;  A. Krištúfková 1;  J. Daniš 1;  B. Némethová 1;  P. Kaščák 2;  Z. Nižňanská 1
Authors‘ workplace: I. gynekologicko-pôrodnícka klinika LF UK a UNB, Bratislava, Slovenská republika, prednosta prof. MUDr. M. Borovský, CSc. 1;  Gynekologicko-pôrodnícka klinika TnUAD, Trenčín, primár MUDr. P. Kaščák, PhD. 2
Published in: Ceska Gynekol 2019; 84(2): 129-139
Category:

Overview

Objective: Analysis of maternal morbidity and mortality in Slovak Republic in the years 2007–2015.

Design: Prospective epidemiological perinatological nation-wide.

Settings: 1st Department of Gynaecology and Obstetrics Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic.

Methods: The analysis of selected maternal morbidity and mortality data prospective collected in the years 2007–2015.

Results: Cesarean section rate progressively increased from 24.1% in the year 2007 up to 30.8% in the year 2013 and up to year 2015 decreased to 30.2%. Vacuum-extraction frequency was 1.3% in the year 2007 and to the year 2015 increased up to 1.6%. Forceps frequency was the same in the year 2007 and 2015: 0.6%. In the years 2008–2015 frequency of perineal tears 3th and 4th degree increased from 0.44% to 0.68% and frequency of episiotomies decreased from 74.7% to 57.2%. In the years 2012–2015 incidence of total severe acute maternal morbidity per 1,000 births was 5.85, peripartum hysterectomy 0.78, severe postpartum bleeding 2.03, transport to anaesthesiology department/intensive care unit 1.26, eclampsia 0.2, HELLP syndrome 0.6, abnormal placental invasion 0.38, uterine rupture 0.45, severe sepsis in pregnancy and puerperium 0.14 and frequency of nonfatal amniotic fluid embolism was 2/100,000 maternities. Total maternal mortality ratio in this period was 11.5 and pregnancy-related deaths ratio 9.9 per 100,000 live births.

Conclusion: The highest cesarean section rate in Slovakia, 30.8 %, was in the year 2013, but in the next years slowly decreased. Frequency of episiotomies decreased in followed period too. Incidence of severe acute maternal morbidity was 5.85 per 1,000 births. Maternal mortality ratio in Slovakia was one of the highest in European Union and not corresponding with good level of perinatal mortality. Improving of cesarean section rate and episiotomy, incidence of severe acute maternal morbidity and maternal mortality still need to be improved in Slovak Republic.

Keywords:

forceps delivery – cesarean section – vacuumextraction – perineal tears – episiotomy – severe acute maternal morbidity – peripartum hysterectomy – Eclampsia – amniotic fluid embolism – maternal mortality – HELLP syndrome


Sources

1. Al-Zirqi, I., Vangen, S., Forsen, LA., et al. Prevalence and risk factors of severe obstetric haemorrhage. BJOG, 2008, 115, 10, p. 1265–1272.

2. Brace, V., Kernaghan, D., Penney, G. Learning from adverse clinical outcomes: major obstetric haemorrhage in Scotland, 2003–2005. BJOG, 2007, 114, 11, p. 1388–1396.

3. Carroli, G., Mignini, L. Episiotomy for vaginal birth. Cochrane Database of Systematic Reviews 2009; 1. CD000081. http://www.thecochranelibrary.com

4. Daniš, J., Korbeľ, M., Krištúfková, A., et al. Analýza prípadov závažného popôrodného krvácania v Slovenskej republike v rokoch 2012–2015. Gynekol prax, 2018, 16, 1, s. 33–37.

5. Deneux-Tharaux, C., Dupont, C., Colin, C., et al. Multifaceted intervention to decrease the rate of severe postpartum haemorrhage: the PITHAGORE6 cluster-randomised controlled trial. BJOG, 2010, 117, 10, p. 1278–1287.

6. Euro-Peristat Project with SCPE, EUROCAT & EURONEOSTAT. European Perinatal Health Report 2008. Data from 2004. 280 p. Available www.europeristat.com

7. Euro-Peristat Project with SCPE and EUROCAT. European Perinatal Health Report. Health and care of pregnant women and babies in Europe in 2010. May 2013. 252 p. Available www.europeristat.com

8. Feyereisl, J., Krofta, L., Křepelka, P. Postpartální hemoragie. 1. vyd. Praha: Mladá fronta, 2018, 359 s.

9. FIGO committee report. Safe matherhood. Int J Gynecol Obstet, 2013, 120, 3, p. 312–313.

10. Fitzpatrick, KE., Sellers, S., Spark, P., et al. Incidence and risk factors for placenta accreta/increta/percreta in the UK: a national case-control study. PLoS One, 2012, 7, 12, e52893.

11. Fitzpatrick, KE., Kurinczuk, JJ., Alfirevic, Z., et al. Uterine Rupture by Intended Mode of Delivery in the UK: A National Case-Control Study. PLoS Med, 2012, 9, 3, e1001184.

12. Fitzpatrick, KE., Tuffnell, D., Kurinczuk, JJ., et al. Incidence, risk factors, management and outcomes of amniotic-fluid embolism:a population-based cohort and nested case-control study. BJOG, 2015, 23, 1, p. 100–109.

13. Garmi, G., Salim, R. Epidemiology, etiology, diagnosis, and management of placenta accreta. Obstet Gynecol Int, 2012, 2012, 873929. doi: 10.1155/2012/8739.

14. Hofmeyr, GJ., Say, L., Gülmezoglu, AM. WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture. BJOG, 2005, 112, 9, p. 1221–1228.

15. Hogan, CM., Foreman, JK., Naghavi, M., et al. Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet, 2010, 375, 9726, p. 1609–1623.

16. Chen, M., Zhang, L., Wei, Q., et al. Peripartum hysterectomy between 2009 and 2010 in Sichuan, China. Int J Gynecol Obstet, 2013, 120, 2, p. 183–186.

17. Kayem, G., Anselem, O., Schmitz, T., et al. Conservative versus radical management in cases of placenta accreta: a historical study. J Gynecol Obstet Biol Reprod, 2007, 36, 7, p. 680–687.

18. Knight, M., on behalf of UKOSS: Eclampsia in the United Kingdom 2005. BJOG, 2007, 114, 9, p. 1072–1078.

19. Knight, M., Kurinczuk, JJ., Spark, P., et al. Cesarean delivery and peripartum hysterectomy. Obstet Gynecol, 2008, 111, 1, p. 97–105.

20. Knight, M. The International Network of Obstetric Survey System (INOSS): benefits of multi-country studies of severe and uncommon maternal morbidities. Acta Obstet Gynecol Scand, 2014, 93, 2, p. 127–131.

21. Korbeľ, M., Borovský, M., Danko, J., et al. Regionálna analýza perinatálnych výsledkov v SR za rok 2007. Gynekol prax, 2009, 7, 1, s. 9–14.

22. Korbeľ, M., Borovský, M., Danko, J., et al. Analýza materskej mortality v SR za rok 2007. Gynekol prax, 2009, 7, 1, s. 26–29.

23. Korbeľ, M., Borovský, M., Danko, J., et al. Analýza perinatálnych výsledkov v SR za rok 2008. Gynekol prax, 2010, 8, 1, s. 37–43.

24. Korbeľ, M., Borovský, M., Danko, J., et al. Analýza perinatálnych výsledkov v SR za rok 2009. Gynekol prax, 2010, 8, 4, s. 193–199.

25. Korbeľ, M., Borovský, M., Danko, J., et al. Analýza perinatálnych výsledkov v SR za rok 2010. Gynekol prax, 2011, 9, 2, s. 95–102.

26. Korbeľ, M., Borovský, M., Danko, J., et al. Analýza materskej mortality v SR za rok 2008. Gynekol prax, 2011, 9, 1, s. 29–34.

27. Korbeľ, M., Borovský, M., Danko, J., et al. Materská úmrtnosť v Slovenskej republike v rokoch 2007–2009. Bedeker zdravia 2011, (suppl. Gynekológia), s. 30–31.

28. Korbeľ, M., Borovský, M., Danko, J., et al. Analýza perinatologických výsledkov Slovenskej republiky v rokoch 2007–2009. Čes Gynek, 2011, 76, 1, s. 18–24.

29. Korbeľ, M., Borovský, M., Danko, J., et al. Analýza materskej morbidity v Slovenskej republike v roku 2011. Gynekol prax, 2013, 11, 1, s. 20–24.

30. Korbeľ, M., Borovský, M., Danko, J., et al. Analýza materskej morbidity v Slovenskej republike v roku 2012. Gynekol prax, 2014, 12, 1, s. 13–19.

31. Korbeľ, M., Borovský, M., Danko, J., et al. Materská mortalita v Slovenskej republike v roku 2009 – I. (priama materská úmrtnosť). Gynekol prax, 2014, 12, 1, s. 30–35.

32. Korbeľ, M., Borovský, M., Danko, J., et al. Materská mortalita v Slovenskej republike v roku 2009 – II. (nepriama a náhodná materská úmrtnosť). Gynekol prax, 2014, 12, 1, s. 37–43.

33. Korbeľ, M., Borovský, M., Danko, J., et al. Materská mortalita v Slovenskej republike v rokoch 2007–2009. Gynekol prax, 2014, 12, 1, s. 26–29.

34. Korbeľ, M., Borovský, M., Danko, J., et al. Analýza materskej morbidity v Slovenskej republike v roku 2013. Gynekol prax, 2015, 13, 4, s. 160–166.

35. Korbeľ, M., Borovský, M., Danko, J., et al. Materská mortalita v Slovenskej republike v rokoch 2010–2012. Gynekol prax, 2015, 13, 4, s. 192–195.

36. Korbeľ, M., Borovský, M., Danko, J., et al. Analýza materskej morbidity v Slovenskej republike v roku 2014. Gynekol prax, 2016, 14, 2, s. 66–72.

37. Korbeľ, M., Borovský, M., Danko, J., et al. Materská mortalita v Slovenskej republike v roku 2010. Gynekol prax, 2016, 14, 2, s. 73–78.

38. Korbeľ, M., Némethová, B., Borovský, M., et al. Incidencia cisárskeho rezu v Slovenskej republike v rokoch 2007–2015. Gynekol prax, 2016, 14, 2, s. 84–90.

39. Korbeľ, M., Krištúfková, A., Dugátová, M., et al. Analýza materskej morbidity a mortality v Slovenskej republike v rokoch 2007–2012. Čes Gynek, 2017, 82, 1, s. 6–15.

40. Korbeľ, M., Krištúfková, A., Dugátová, M., et al. Analýza materskej morbidity v Slovenskej republike v roku 2015. Gynekol prax, 2017, 15, 1, s. 18–24.

41. Korbeľ, M., Havalda, A., Nižňanská, Z., et al. Incidencia epiziotómií v Slovenskej republike v rokoch 2008–2015. Gynekol prax, 2017, 15, 1, s. 40–45.

42. Korbeľ, M., Krištúfková, A., Nižňanská, Z., et al. Materská mortalita v Slovenskej republike v rokoch 2013–2015. Gynekol prax, 2017, 15, 1, s. 46–49.

43. Krištúfková, A., Korbeľ, M., Borovský, M., et al. Analýza závažnej akútnej materskej morbidity v Slovenskej republike v roku 2012. Gynekol prax, 2015, 13, 4, s. 185–191.

44. Krištúfková, A., Korbeľ, M., Daniš, J., et al. Analýza závažnej akútnej materskej morbidity v Slovenskej republike v roku 2015. Gynekol prax, 2016, 14, 2, s. 92–98.

45. Krištúfková, A., Korbeľ, M., Daniš, J., et al. Analýza závažnej akútnej materskej morbidity v Slovenskej republike v roku 2014. Gynekol prax, 2017, 15, 1, s. 25–32.

46. Kristufkova, A., Borovsky, M., Korbel, M., et al. Amniotic fluid embolism – investigation of fatal cases in Slovakia in the years 2005–2010 compared with fatal cases in the United Kingdom. Biomed Pap med Fac Univ Palacky Olomouc Czech Repub, 2014, 158, 3, p. 397–403.

47. Lalonde, A. FIGO Committee for Safe Motherhood and Newborn Health. Prevention and treatment of postpartum hemorrhage in low resource setting. FIGO Guidelines. Int J Gynecol Obstet, 2012, 117, 2, p. 108–118.

48. Mlynček, M., Kellner, M., Uharček, P., a spol. Peripartálne hysterektómie – audit na Slovensku v roku 2007. Čes Gynek, 2010, 75, 2, s. 88–92.

49. Sentilhes, L., Kayem, G., Ambroselli, C., et al. Fertility and pregnancy outcomes following conservative treatment for placenta accreta. Hum Reprod, 2010, 25, 11, p. 2803–2810.

50. Tunçalp, O., Souza, JP., Gülmezoglu, M. New WHO recommendations on prevention and treatment of postpartum hemorrhage. Int J Gynaecol Obstet, 2013, 123, 3, p. 254–256.

51. Vais, A., Bewley, S. Severe acute maternal morbidity. In: B-Lynch, C., Keith, L.G., Lalonde, A.B., et al. A textbook of postpartum hemorrhage. 1st ed. UK: Sapiens Publishing, 2006, p. 339–352.

52. Vandenberghe, G., Bloemenkamp, K., Berlage, S., et al. The International Network of Obstetric Survey Systems study of uterine rupture: a descriptive multi-country population – based study. BJOG 2018; https://doi.org/10.1111/1471-0528.15271

53. van Dillena, J., Zwartb, J., Schuttec, J., et al. Maternal sepsis: epidemiology, etiology and outcome. Curr Opin Infect Dis, 2010, 23, 3, p. 249–254.

54. Velebil, P. Analýza výsledků perinatální péče v ČR za rok 2015. XXXIII. Celostátní konference perinatologie a fetomaternální medicíny s mezinárodnou účastí. Ústí nad Labem, 7.–9. 4. 2016.

55. WHO. Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNFPA, and the World Bank. Geneva: World Health Organisation, 2008, 40 p.

56. WHO. Trends in maternal mortality: 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: World Health Organization, 2015, 77 p.

57. Zahn, CM., Yeomans, ER. Postpartum hemorrhage: placenta accreta, uterine inversion, and puerperal hematomas. In Clin Obstet Gynecol, 1990, 33, 3, p. 422–431.

58. Zwart, JJ., Richters, JM., Ory, F., et al. Severe maternal morbidity during pregnancy, delivery and puerperium in the Netherlands: a nationwide population-based study of 371 000 pregnancies. BJOG, 2008, 115, 7, p. 842–85.

59. Xie, R., Gaudet, L., Krewski, D., et al. Higher cesarean delivery rates are associated with higher infant mortality rates in industrialized countries. Birth, 2015, 1, p. 62–69.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

Article was published in

Czech Gynaecology

Issue 2

2019 Issue 2

Most read in this issue
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account