Doctoral Degrees (Obstetrics and Gynaecology)

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Browsing Doctoral Degrees (Obstetrics and Gynaecology) by browse.metadata.advisor "De Vries, Johanna Inge Petra"

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    Maternal deaths, near misses and great saves. Severe maternal outcome in Metro East, Western Cape Province, South Africa
    (Stellenbosch : Stellenbosch University, 2023-12) Heitkamp, Anke; Theron, Gerhardus Barnard; De Vries, Johanna Inge Petra; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. Obstetrics and Gynecology.
    ENGLISH ABSTRACT: Objective To assess the incidence of Severe Maternal Outcome (SMO), comprising maternal mortality (MM) and near miss (MNM), in Metro East healthdistrict, Western Cape Province, South Africa between November 2014 and November 2015 and identify associated determinants leading to SMO with the aim to improve maternity care. Methods Design: Region wide population-based case control study. Women were included in the study, if they were maternal deaths or met MNM criteria, both as defined by World Health Organization. Characteristics of women with SMO were compared with a sample of women without SMO, matched for age and parity, taken from midwifery-led obstetric units from two residential areas in Metro East, using multivariate regression analysis. Results Incidence of SMO was 9.1 per 1000 livebirths, of MNM 8.6 per 1000 live births. Main causes of SMO were obstetric hemorrhage and hypertensive disorders. Factors associated with SMO were HIV (adjusted odds ratio (aOR) 24.8; 95% confidence interval (95% CI) 10.0 – 61.6), preeclampsia (aOR 17.5; 95% CI 7.9-38.7), birth by caesarean section (aOR 8.4; 95% CI 5.8-12.3) and chronic hypertension (aOR 2.4; 95% CI 1.1 – 5.1). Conclusion Evaluation of SMO incidence and associated determinants supports optimizing tailored guidelines in Metro-East health district to improve maternal health.