Analysis of maternal morbidity and mortality in Slovak Republic in the years 2007–2012

Česká verzia

Authors: M. Korbeľ ¹; A. Krištúfková ¹ ; M. Dugátová ¹; J. Daniš ¹ ; B. Némethová ¹; P. Kaščák ² ; Z. Nižňanská ¹
Authors place of work: I. gynekologicko-pôrodnícka klinika LF UK a UNB, Bratislava, SR, prednosta prof. MUDr. M. Borovský, CSc. ¹; Gynekologicko-pôrodnícka klinika TnUAD, Trenčín, primár MUDr. P. Kaščák, PhD. ²
Published in the journal: Ceska Gynekol 2017; 82(1): 6-15

Summary

Objective:
Analysis of maternal morbidity and mortality in Slovak Republic (SR) in the years 2007–2012.

Design:
Epidemiological perinatological nation-wide.

Settings:
1st Department of Gynaecology and Obstetrics School 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 2007–2012 from all obstetrics hospitals in the Slovak Republic.

Results:
Caesarean section rate progressively increased from 24.1% in the year 2007 up to 30.3% in the year 2012. In the year 2012 the frequency of vacuum-extraction was 1.4%, forceps 0.6%, perineal tears 3^th and 4^th degree 0.49% and episiotomy 65%. Incidence of total severe acute maternal morbidity was 6.34 per 1,000 births. Incidence (per 1,000 births) of transport to anaesthesiology department/intensive care unit was 2.32, postpartum hysterectomy 0.72, HELLP syndrome 0.63, eclampsia 0.29, abnormal placental invasion 0.37, uterine rupture 0.27, severe sepsis in pregnancy and puerperium 0.21. In the years 2007–2012 frequency of fatal amniotic fluid embolism was 2.46/100,000 maternities or 2.43/100,000 live-births. Maternal mortality ratio in this period was 14 per 100,000 live births and pregnancy-related deaths ratio was 11.9 per 100,000 live births.

Conclusion:
In the year 2012 Slovakia reached the highest caesarean section rate in her own history – 30.3%. Incidence of severe acute maternal morbidity was 6.34 per 1,000 births. Maternal mortality ratio in Slovakia was one of the highest in European Union. Decreasing of caesarean section rate and episiotomy, incidence of severe acute maternal morbidity and maternal mortality still need to be improved in Slovak Republic.

Keywords:
caesarean section, perineal tears 3^th and 4^th degree, episiotomy, postpartum hysterectomy, eclampsia, severe acute maternal morbidity, abnormal placental invasion, amniotic fluid embolism, maternal mortality

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