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Assessing the Impact of the Zero Mother Mortality Preeclampsia Program on Maternal Mortality Rates at a Single Center in Bandung, West Java (2015–2022): A Retrospective Study

Authors
  • Pribadi, Adhi1
  • Hidayat, Dini2
  • Sasotya, R.M. Sonny3
  • Aziz, Muhammad Alamsyah1
  • Nurdiawan, Windi2
  • Pramatirta, Akhmad Yogi1
  • Siddiq, Amillia1
  • Mose, Johanes Cornelius1
  • Hidayat, Yudi Mulyana3
  • Nugrahani, Annisa Dewi1
  • Santoso, Dhanny Primantara Johari1
  • Permadi, Wiryawan4
  • 1 Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Bandung, Indonesia
  • 2 Social Obstetrics and Gynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Bandung, Indonesia
  • 3 Indonesian Society of Obstetrics and Gynecology (POGI), Bandung, West Java, Indonesia
  • 4 Reproductive Fertility Endocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Bandung, Indonesia
Type
Published Article
Journal
Medical Science Monitor
Publisher
"International Scientific Information, Inc."
Publication Date
Jul 23, 2023
Volume
29
Identifiers
DOI: 10.12659/MSM.941097
PMID: 37481698
PMCID: PMC10373510
Source
PubMed Central
Keywords
Disciplines
  • Clinical Research
License
Unknown

Abstract

Background The Zero Mother Mortality Preeclampsia (ZOOM) program was adopted as an accelerated initiative to curb mortality related to hypertensive disorders in pregnancy, including preeclampsia. This single-center, retrospective study in Bandung, West Java, aims to evaluate the impact of the ZOOM program implemented from 2015 to 2022. Material/Methods We analyzed 19,176 childbirths and associated maternal deaths due to hypertension in pregnancy. Diagnoses were validated using blood pressure measures, lab tests including urine protein, liver function, blood profiles, platelets, X-ray, echocardiography, and COVID-19 testing. The case fatality rate (CFR) was assessed to evaluate the impact of the ZOOM program. Results Hypertension in pregnancy was identified in 25.1% of cases, with 9.8% and 1.4% attributed to preeclampsia and eclampsia, respectively. Maternal deaths associated with hypertension accounted for 36.6%, with the majority linked to eclampsia. Heart failure (45.5%) and Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome (22%) were the most common complications. The CFR decreased from 61% in 2018 to 10% in 2022. The overall CFR from 2015 to 2022 was 1.3%, with the highest fatality rate observed in eclampsia cases (9.4%). However, a declining trend was seen since 2018, reaching a low of 0.2% in 2021. Conclusions The implementation of the ZOOM program, which includes preeclampsia re-education, early detection, prompt intervention, protocol adjustments, and a refined referral system, led to a marked reduction in maternal deaths from hypertensive pregnancy disorders.

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