WHO EMRO | Near-miss cases admitted to a maternal intensive care unit, Alexandria, Egypt PDF version Eman A. Sultan  1 , Safia I. Shehata  1 , Salwa S. Shaarawy  2 and Mona H.H. Ashry  1 دﺨﻠﺖ وﺤدﺔ اﻠﻌﻨاﻴﺔ اﻠﻤرﻜزﺔ دراﺴﺔ ﻟﻠﺤاﻠاﺖ اﻠﺘﻲ ﺷارﻔﺖ ﻋﻠﻰ اﻠوﻔاﺔ وﺄ ﻟﻠأﻤﻬاﺖ، اﻠإﺴﻜﻨدرﻴﺔ، ﻣﺼﺮ إﻴﻤاﻦ أﻨوﺮ ﺳﻠﻄاﻦ، ﺻﻔﻴﺔ إﺒراﻬﻴﻢ ﺷﺤاﺘﺔ، ﺳﻠوﻰ ﺷﻌﺒاﻦ ﺷﻌراوﻲ، ﻣﻨﻰ ﺣﻤدﻲ ﻋﺸرﻲ اﻠﺨﻠاﺼﺔ ﻋرﻒ اﻠﻨﺠاﺔ ﻣﻦ ﻣﻀاﻌﻔاﺖ اﻠﺤﻤﻞ اﻠﺤادﺔ ﺑاﺴﻢ اﻠﺤاﻠاﺖ اﻠﻤﺸرﻔﺔ ﻋﻠﻰ اﻠوﻔاة؛ إﻠﺎ :ﺕ أﻦ اﻠدراﺴاﺖ اﻠﻤﺘﻌﻠﻘﺔ ﺑاﻠﺤاﻠاﺖ اﻠﻤﺸرﻔﺔ ﻋﻠﻰ اﻠوﻔاﺔ أﺜﻨاء اﻠﺤﻤﻞ وﺤوﻞ اﻠوﻠادﺔ ﻗﻠﻴﻠﺔ ﺿﺔ وﺘﺸﺨﻴﺺ اﻠﺤاﻠاﺖ اﻠﻤﺸرﻔﺔ ﻋﻠﻰ اﻠﻌدﺪ ﻓﻲ إﻘﻠﻴﻢ ﺷرﻖ اﻠﻤﺘوﺴﻂ. وﻠﺘﺤدﻴﺪ اﻠﻌواﻤﻞ اﻠﻤﻌﺮ اﻠوﻔاﺔ، ﺗﻢ ﺗﻘﻴﻴﻢ اﻠﻤرﻴﻀاﺖ اﻠﻠاﺘﻲ ﺗﻢ إدﺨاﻠﻬﻦ "وﺤدﺔ اﻠﻌﻨاﻴﺔ اﻠﻤرﻜزﺔ ﻟﻠأﻤﻬاﺖ" ﺑﻤﺴﺘﺸﻔﻰ ﺣاﻠﺔ448 اﻠﺸاﻄﺒﻲ اﻠﺠاﻤﻌﻲ ﻓﻲ اﻠإﺴﻜﻨدرﻴﺔ ﺑﻤﺼﺮ. وأﺠرﻲ ﻣﺴﺢ اﺴﺘﺒاﻘﻲ ﺗﻀﻤﻦ ﻣﻘاﺒﻠاﺖ ﻣﻊ اﺴﺘوﻔﺖ ﻣﻌاﻴﻴﺮ ﻣﻨﻈﻤﺔ اﻠﺼﺤﺔ اﻠﻌاﻠﻤﻴﺔ اﻠﻤﺘﻌﻠﻘﺔ ﺑاﻠﻤﺸرﻔﺔ ﻋﻠﻰ اﻠوﻔاﺔ أﺜﻨاء اﻠﺤﻤﻞ وﺤوﻞ 2014 اﻠوﻠادﺔ وﺘﻢ إدﺨاﻠﻬﺎ "وﺤدﺔ اﻠﻌﻨاﻴﺔ اﻠﻤرﻜزﺔ ﻟﻠأﻤﻬاﺖ" ﺑﻤﺴﺘﺸﻔﻰ اﻠﺸاﻄﺒﻲ ﺧﻠاﻞ ﻋاﻢ واﺴﺘﻌراﺾ ﺳﺠﻠاﺘﻬﺎ وﻤﺘاﺒﻌﺘﻬﺎ ﻟﺘﻘﻴﻴﻢ ﻧﺘاﺌﺠﻬﺎ. وارﺘﺒﻂ اﻨﺨﻔاﺾ ﻣﺴﺘوﻰ ﺗﻌﻠﻴﻢ اﻠأﻤﻬاﺖ وﻌدﻢ ذﺎ دﻠاﻠﺔ ﺑﻤﻌدﻞ وﻔﻴاﺖ اﻠأﻤﻬاﺖ. وﺸﻜﻞ ﻛﻔاﻴﺔ اﻠرﻌاﻴﺔ ﻓﻲ ﻓﺘرﺔ ﻣﺎ ﻗﺒﻞ اﻠوﻠادﺔ ارﺘﺒاﻄﺎ ﻟإدﺨاﻞ اﻠأﻤﻬاﺖ ﻟوﺤدﺔ ﺗﺴﻤﻢ اﻠﺤﻤﻞ اﻠﺸدﻴﺪ واﻠﻨزﻒ اﻠﺘاﻠﻲ ﻟﻠوﻀﻊ أﻜﺜﺮ اﻠأﺴﺒاﺐ ﺷﻴوﻌﺎ اﻨﺨﻔاﺾ ﺩ . وﻊ% 8.5 . وﺒﻠﻎ ﻣؤﺸﺮ اﻠوﻔﻴاﺖ( ﻋﻠﻰ اﻠﺘواﻠﻲ% 23.8 ﻭ% 40.2) اﻠرﻌاﻴﺔ اﻠﻤرﻜزﺔ ﻣﺴﺘوﻰ اﻠﺘﻌﻠﻴﻢ وﻌدﻢ ﻛﻔاﻴﺔ اﻠرﻌاﻴﺔ ﻓﻲ ﻣرﺤﻠﺔ ﻣﺎ ﻗﺒﻞ اﻠوﻠادﺔ ﻣﺤددﻴﻦ ﻣﻬﻤﻴﻦ ﻟوﻔﻴاﺖ ﺋﻴﻦ ﻣﻬﻤﻴﻦ ﻟوﻔﻴاﺖ اﻠأﻤﻬاﺖ. ﺩ ﻣﻨﺐ ﻡ وﺨﻠﻞ اﻠأﻌﻀاء اﻠﻤﺘﻌﺪ ﻝ اﻠﺘﺴﻢ اﻠأﻤﻬاﺖ. وﺸﻚ ABSTRACT Survival of severe pregnancy complication is known as maternal near-miss; however, studies on maternal near-miss are few in the Eastern Mediterranean Region. To identify the predisposing factors and diagnoses of near-miss cases, patients admitted to the maternal intensive care unit of El-Shatby University Hospital in Alexandria, Egypt, were assessed. A prospective survey was conducted where 448 cases that fulfill the WHO criteria of near-miss and admitted to El Shatby maternal intensive care unit during 2014 were interviewed, their records were reviewed and were followed up to assess their outcome. Low maternal education and inadequate antenatal care were significantly associated with maternal mortality. Severe pre-eclampsia and post-partum hemorrhage were the most common causes of admission (40.2% and 23.8% respectively). Mortality index was 8.5%. Sepsis and multiple organ dysfunction were significant predictors of maternal mortality. Étude des cas de décès évités de justesse admis en unité de soins 1 / 12