Characteristics of Extreme Maternal Morbidity at the Regional Hospital of Ayacucho, Peru, 2021-2023

Abstract

Extreme maternal morbidity (EMM), according to WHO, is a condition in which a
woman nearly almost loses her life due to complications during pregnancy, childbirth,
or the postpartum period. This rate is higher in low- and middle-income countries.
Although maternal mortality has declined in Peru, the EMM is not fully described,
underlining the importance of its analysis to improve maternal health services.
Objective: To describe EMM in the Regional Hospital of Ayacucho, Peru, between
June 2021 and June 2023, and to analyze key indicators to improve maternal care.
Materials and methods: An observational, retrospective, cross-sectional study was
conducted with 100 cases of EMM. Socio-demographic data, obstetric characteristics,
pathological history and interventions were assessed using epidemiological
surveillance forms and formulas to calculate the EMM, maternal mortality ratio and
other metrics. Results: The mean age of the patients was 28 years, mostly cohabiting
women with secondary education. The most frequent criteria for EMM were severe
hypoxia (50%) and cardiovascular compromise (39%). HELLP syndrome (30%) and
postpartum hemorrhage (22%) were the most common complications. The EMM was
19.4 per 1,000 live births and the maternal mortality ratio was 5.75 per 100 cases of
EMM. Conclusions: The EMM in Ayacucho (2021-2023) reveals severe complications
mainly in young women with low educational level. It is crucial to implement effective
prevention and management strategies to reduce its incidence and improve obstetric
outcomes.