<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0138-600X</journal-id>
<journal-title><![CDATA[Revista Cubana de Obstetricia y Ginecología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Obstet Ginecol]]></abbrev-journal-title>
<issn>0138-600X</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0138-600X2019000300006</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Adherencia a las buenas prácticas clínicas en el manejo de la morbilidad materna extremadamente grave]]></article-title>
<article-title xml:lang="en"><![CDATA[Adherence to Good Clinical Practices in Managing Extremely Severe Maternal Morbidity]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Suárez González]]></surname>
<given-names><![CDATA[Juan Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gutiérrez Machado]]></surname>
<given-names><![CDATA[Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Quincose Rodríguez]]></surname>
<given-names><![CDATA[Marien]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez Pérez]]></surname>
<given-names><![CDATA[Yanet]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez Melendrez]]></surname>
<given-names><![CDATA[Beatríz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Ginecobstétrico &#8220;Mariana Grajales&#8221;  ]]></institution>
<addr-line><![CDATA[Santa Clara ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2019</year>
</pub-date>
<volume>45</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0138-600X2019000300006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0138-600X2019000300006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0138-600X2019000300006&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La vigilancia de la morbilidad materna extrema es complemento para la evaluación y mejoramiento de la calidad de los servicios de salud.  Objetivo:  Evaluar la adherencia a las buenas prácticas clínicas en el manejo de la morbilidad materna extremadamente grave.  Métodos:  Se realizó un estudio descriptivo transversal en el Hospital Universitario Ginecobstétrico Mariana Grajales, Villa Clara, Cuba, desde el 2012 al 2015 en mujeres con morbilidad materna extremadamente grave. De las 577 pacientes atendidas se escogió una muestra intencional de 93. Además, fueron revisados los documentos de archivo del hospital y las historias clínicas individuales y hospitalarias.  Resultados:  En la consulta de atención primaria fueron registrados 80 casos como riesgo obstétrico, en consultas de re-evaluación realizadas a las 14,1 semanas como promedio, solo 88,2 % habían realizado los exámenes complementarios iniciales y solo 94,6 %, tenían reflejado en su carné obstétrico el control de las curvas de tensión y peso. La altura uterina solo apareció reflejada en 96,8 % de los casos. En la atención secundaria se aplicó el código de colores a 92 pacientes y se identificó el riesgo obstétrico en 91. Fueron diagnosticadas al ingreso 85 mujeres. Se aplicaron los protocolos de atención al puerperio y de seguimiento por la comisión de la institución en todos los casos.  Conclusiones:  Se detectan deficiencias en el proceso de atención a la morbilidad materna extremadamente grave. En este período fueron evaluados como aceptables la captación precoz, la atención al puerperio (inmediato y mediato) y el seguimiento por la comisión de morbilidad materna extremadamente grave de la institución.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Surveillance of extreme maternal morbidity is a complement to the assessment and improvement of the quality of health services.  Objective:  To evaluate adherence to good clinical practices in Managing Extremely Severe Maternal Morbidity.  Methods:  A descriptive cross-sectional study was carried out in women with extremely severe maternal morbidity at Mariana Grajales Gyneco-Obstetric University Hospital, Villa Clara, Cuba, from 2012 to 2015. An intentional sample of 93 was chosen from 577 patients treated. In addition, the hospital records and individual and hospital medical records were reviewed.  Results:  In the primary care clinic 80 cases were registered as obstetric risk. Only 88.2% had performed the initial complementary exams in re-evaluation consultations conducted at 14.1 weeks on average. Moreover, 94.6% had registered tension and weight curves in their obstetric control card. Uterine height only appeared registered in 96.8% of cases. In secondary care, color code was applied in 92 patients and obstetric risk was identified in 91. Upon admission, 85 women were diagnosed. Puerperium care and follow-up protocols were applied by the institution's commission in all cases.  Conclusions:  Deficiencies are detected in the process of providing care to extremely severe maternal morbidity. During this period, early pregnancy uptake, care for the immediate and mediate puerperium and follow-up by the institution's extremely serious maternal morbidity commission were assessed as acceptable.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[morbilidad obstétrica extremadamente grave]]></kwd>
<kwd lng="es"><![CDATA[muerte materna]]></kwd>
<kwd lng="es"><![CDATA[hemorragia obstétrica]]></kwd>
<kwd lng="es"><![CDATA[trastornos hipertensivos]]></kwd>
<kwd lng="en"><![CDATA[extremely severe obstetric morbidity]]></kwd>
<kwd lng="en"><![CDATA[maternal death]]></kwd>
<kwd lng="en"><![CDATA[obstetric hemorrhage]]></kwd>
<kwd lng="en"><![CDATA[hypertensive disorders]]></kwd>
</kwd-group>
</article-meta>
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