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BackgroundMaternal morbidity and mortality pose a significant impact on national public health, being medical attention of obstetric emergencies (OE) and non-emergencies (ONE) of capital importance.MethodsDescriptive and epidemiologic analysis of OE/ONE at a 3rd level military echelon.ResultsDuring a 34-months span, 48 patients were approached at the emergency department (1.4 admissions/month). Mean age: 29 ± 3 years (17-41). Eight patients (17%) were considered OE and 40 (83%) ONE. Fifty-eight percent (n = 28) of patients were admitted to our institution; 32% (n = 9) were managed under non-surgically basis and 68% (n = 19) underwent surgical therapy. Most important cause of admission: postoperative hemorrhage (22%; n = 6). Most frequent operative interventions: surgical hemostasis maneuvers (31.5%; n = 6). Eighty-two percent (n = 23) of admissions required management at intensive care unit (ICU), with mean length of stay of 6.4 ± 4.9 days (2-21). Thirty-five percent (n = 8) required mechanical ventilation. Mean score of APACHE II at ICU: 19.4 ± 8.4; predicted probability of death: 35.5%. Global morbidity rate: 27% (1.8 complications/patient). Global mortality rate: 6.2%; specific mortality for pregnant patients 0% (n = 0) and for post-partum patients 12.5% (n = 3). Mortality rate at ICU: 4.3% (n = 1).ConclusionsCentral Military Hospital has delineated and defined several procedures to decrease maternal morbidity and mortality. Appropriate practice of these procedures contributes to reach the desired institutional objectives.

Obstetric emergencies and non-emergencies at Central Military Hospital (I): Our vision and the epidemiologic horizon