Rise in number of women experiencing severe medical complications in pregnancy

The number of Irish mothers with serious maternal medical complications is increasing.

An eight-year study of serious pregnancy- or childbirth-related conditions at the Rotunda maternity hospital in Dublin found that the most common case was hypertensive disorders of pregnancy. I had sepsis.

During the study period, 81,504 women used obstetric services at the hospital and had 67,894 deliveries. A total of 504 women had severe maternal disease. That number increased from 6 per 1,000 to 9 per 1,000 from 2012 to 2019.

The study’s lead author, Dr. Claire McCarthy, said the data showed an increase in women with multiple pregnancies and non-Irish women with serious medical complications.

Dr. McCarthy notes that multiple pregnancy rates for severe maternal morbidity have “increased four-fold since 2012,” while other studies have shown that “people from minority groups have higher rates of complications for a variety of reasons.” ‘, he added.

Consultant obstetricians and gynecologists said these women may have a “language barrier” and “potentially cannot communicate the importance of their illness or be aware of how to access services.” No,” he said.

Overall, nearly 9% of documented complications were multiple pregnancies, and almost one-fifth required escalation to a general hospital. About 1 in 7 of her required cardiac or intensive care management.

On average, 61.2% of women were recorded as Irish, indicating the “ethnically diverse nature of women” attending maternity hospitals, the survey said.

There were no differences in maternal age, nationality, or body mass index between the years analyzed. In a study just published in AJOG Global Report The majority of complications occurred late in pregnancy or after birth, according to the journal. The third trimester accounted for 58% of cases and 42% of cases occurred postnatally.

Over the 8-year period, the most common serious maternal morbidity was gestational hypertension, accounting for 45% of cases, followed by postpartum haemorrhage, accounting for 44% of cases, and sepsis being the severe maternal morbidity case. accounted for 12% of

Postpartum haemorrhage (abnormal or excessive bleeding after childbirth), which accounted for more than 90% of severe complications in 2012, dropped to more than 50% in 2019.

Dr McCarthy said this was largely due to the focus of the National Center for Perinatal Epidemiology at University College Cork on the issue, saying, “It’s totally gone down.”

“Its management has been greatly strengthened by protocols and policies. If there is more than 1,500ml or 2,000ml of bleeding, a large obstetric package is initiated or warned. shows in.”

Hypertension or severe hypertension cases increased from just over 20% in 2012 to just under 30% in 2019.

” [cases] is fluctuating.This is severe hypertension requiring admission to a highly dependent ward [such as] Severe pre-eclampsia or HELLP syndrome or eclampsia,” says Dr. McCarthy.

Sepsis remained relatively stable during the period. “Sepsis is a serious bacterial infection. It will be considered one of the leading causes of death in women,” said Dr. McCarthy. “There are different stages to it.

Overall, Dr McCarthy said Ireland is considered “a safe place to have a baby” and the findings match international standards.

She said there is concern that more women will enter pregnancy with pre-existing medical conditions.

“The biggest concern and change during this period is that more women are entering pregnancy with more complex medical histories,” she said.

“This is increasing, probably due to a number of factors. [including] Developments and advances in medical and pharmacological care, as well as lifestyle and demographics. ”

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