Additional file 1: of Birth preparedness and complication readiness among pregnant women admitted in a rural hospital in Rwanda

Consent form and questionnaire. Consent form as used in the study and questionnaire adapted from the ‘Safe Motherhood questionnaire’, as developed by the Maternal Neonatal Program of JHPIEGO, an affiliate of John Hopkins University. (DOCX 63 kb

Additional file 1: of Assessing emergency obstetric and newborn care: can performance indicators capture health system weaknesses?

Questionnaire Facility Audit 2015. (DOCX 550 kb

Overweight and Severe Acute Maternal Morbidity in a Low-Risk Pregnant Population in The Netherlands

<div><p>Objective</p><p>To investigate the association between overweight and severe acute maternal morbidity (SAMM) in a low-risk pregnant population.</p> <p>Design</p><p>Nationwide case-control study.</p> <p>Setting</p><p>The Netherlands, august 2004 to august 2006.</p> <p>Population</p><p>1567 cases from initially primary care and 2994 women from primary care practices as controls, out of 371 012 women delivering in the Netherlands during the study period</p> <p>Methods</p><p>Cases were women with SAMM obtained from a nationwide prospective study. All women in this cohort who initially had low-risk pregnancies were compared with low-risk women without SAMM to calculate odd ratios (ORs) to develop SAMM by body mass index (BMI) category. We divided body mass index in three overweight categories and calculated the ORs (95% CI) of total SAMM and per specific endpoint by logistic regression, with normal weight as reference. We adjusted for age, parity and socio-economic status.</p> <p>Main Outcome Measures</p><p>SAMM, defined as Intensive Care Unit (ICU)-admission, Uterine Rupture, Eclampsia or Major Obstetric Haemorrhage (MOH)</p> <p>Results</p><p>SAMM was reported in 1567 cases which started as low-risk pregnancies. BMI was available in 1097 (70.0%) cases and 2994 control subjects were included. Analysis showed a dose response relation for overweight (aOR, 1.3; 95% CI, 1.0-1.5), obese (aOR, 1.4; 95% CI, 1.1-1.9) and morbidly obese (aOR, 2.1; 95% CI, 1.3-3.2) women to develop SAMM compared to normal weight. Sub analysis showed the same dose response relation for ICU-admission, Uterine Rupture and Eclampsia. We found no association for MOH.</p> <p>Conclusion</p><p>Overweight without pre-existent co-morbidity is an important risk-indicator for developing SAMM. This risk increases with an increasing body mass index.</p> </div

Types of cardiovascular disease and its mortality.

*<p>more than one subcategory possible. PPCM: peripartum cardiomyopathy; CM: cardiomyopathy; CHD: congenital heart disease; ACS: acute coronary syndrome; SVT: supraventricular tachycardia; VT: ventricular tachycardia; SADS: Sudden Arrhythmic Death Syndrome.</p

Characteristics of women with severe maternal morbidity caused by cardiovascular disease.

*<p>not including pregnancy-induced hypertension or (pre) eclampsia,</p>∧<p>more than one option possible. (PP)CM: (peripartum) cardiomyopathy, VALVE: valvular disease, IHD: ischaemic heart disease, ARR: arrhythmias, AD: aortic dissection, MISC: miscellaneous.</p

Comparison of possible risk factors for developing severe maternal morbidity and mortality caused by cardiovascular disease between cases and the general pregnant population.

<p>n/a = data not available. RR = relative risk (95% confidence interval) <b>significant</b>.</p>*<p>includes hypertension, diabetes, cardiac disease and coagulation disorders. National reference values from.</p>**<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0056494#pone.0056494-Statistics1" target="_blank">[11]</a> Statistics Netherlands (exact study period) and.</p>***<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0056494#pone.0056494-LVRLandelijke1" target="_blank">[12]</a> The Netherlands Perinatal Registry (LVR-2, 2005).</p

Difficulties perceived by assessors.

<p>Difficulties perceived by assessors.</p

Agreed solutions.

<p>Agreed solutions.</p

Obstetric history and mode of delivery in women with severe maternal morbidity caused by cardiovascular disease.

<p>(PP)CM: (peripartum) cardiomyopathy, VALVE: valvular disease, IHD: ischaemic heart disease, ARR: arrhythmias, AD: aortic dissection, MISC: miscelaneous.</p

Study details for BP/CR interventions aiming to increase SBA for uncomplicated birth.

<p>Study details for BP/CR interventions aiming to increase SBA for uncomplicated birth.</p