In Brazil, where 90% of the childbirths occur in hospitals, 67.1% of the cases of maternal death are due to direct obstetric causes, mainly hypertensive disorders, but a quarter of the deaths are due to indirect obstetric causes. As maternal death is a rare event, estimated in 76/100,000, the study of severe maternal morbidity, following international literature, can contribute to qualify obstetrical care. Maternal morbidity is a continuum that ends with death, but there is a separate group, with extreme severity, known as near miss. From the literature review, there are the difficulties to obtain an operational definition of the cases of extremely severe morbidity or near miss. The prevalence ranged from 0.80-8.23%, according to the defining criteria and health care provided at the region. The characterization of severe maternal morbidity and near miss allows for monitoring the process of obstetrical care and could help to qualify treatment of maternal urgencies and emergencies, interrupting the process that can lead to death.
Maternal mortality; Morbidity; Pregnancy complications; Quality of health care