Causes of delays in obstetric complications care. What is necessary to address?
Elsa Rodríguez-Angulo; Marco Palma-Solís; Rita Zapata-Vázquez
Ginecologia y Obstetricia de Mexico 82(10): 647-658
2014
ISSN/ISBN: 0300-9041 PMID: 25510056 Document Number: 677650
This article reviews the published evidences associated with the causes of delays in cases of maternal death and in those for which the patients survived the obstetric complication, in order to build an analytical framework to identify factors not investigated yet, as part of the search for a preventive model of maternal risk. We reviewed articles in the PubMed, EBSCO and Web of Science database using the following keywords: delays, maternal, mortality. Latin American items were extracted from the Google Scholar database. Three types of delays were analyzed: in seeking care (first delay) in reaching care (second delay), and in diagnosis and treatment (third delay). The main causes of the first delay were lack of decision to seek care at the time of complication (79%) and not recognizing the warm signs of the complication (82.1%). The second delay was mainly due to the lack of transport (92.3%) at the time of transfer to another hospital. The third delay was related to poor quality of care in health services (63%). Educational interventions appropriate to the context are required to integrate knowledge of warning signs and conditions of gender. Studies are needed to analyze the causes of delay in health services in order to be able to propose preventive models aimed at their reduction.