Annals of medicine · 2026
Maternal critical care infrastructure and organisational preparedness in Türkiye: a national analysis of the MaCriCare cross-sectional survey.
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Günaydın Dudu Berrin, Erel Selin, Özdemir Miray Gözde, Ünver Çiğdem Naz, Krawczyk Paweł, Cantellow Steve, Dabrowska Dominika
Аннотация
OBJECTIVES: MaCriCare (Maternal Critical Care) study, created as a European initiative, evaluated the availability of maternal critical care services. Since unique strengths and challenges of Turkish data within the MaCriCare study have not yet been evaluated separately, we aimed to assess maternal critical care preparedness and organisation in Turkish obstetric units participating in the MaCriCare cohort.
METHODS: This secondary analysis included validated unit responses collected from September 2021 to January 2022. Survey domians including access to an intensive care unit (ICU), modified early-obstetric warning-score (MEOWS) use, availability of critical-care resources, care locations for pre-eclampsia, postpartum haemorrhage (PPH) and sepsis, and maternal/staff support by focusing service accessibility and annual delivery rate were used. The comparator comprised 993 non-Türkiye units, and 140 Turkish units from 1,133-unit MaCriCare cohort.
RESULTS: Responses from 140/403 eligible units (34.7%) represented 305,250 annual deliveries where 501-1,500 and 1,501-3,000 annual deliveries comprised 32.1% and 30.0%, respectively. Rate of same-hospital ICU access was 78.6% and 82.4% and use of any MEOWS system was 27.9% and versus 35.4% in Turkish vs non-Türkiye units, respectively. For pre-eclampsia, 58/140 units (41.4%) reported obstetric-unit care before delivery, followed by separate critical care particularly for PPH varied between 62.1% to 82.9%. Sepsis rate was 86.4%. Unavailable advanced resources included cardiac output monitoring (30.0%), cell salvage (47.1%), and viscoelastic testing (67.1%). Rate of breastfeeding support was 92.7% and maternal psychological screening was 24.5%.
CONCLUSIONS: Describing maternal critical-care infrastructure and reported organisational arrangements among participating Turkish units may support future service assessment and planning.
METHODS: This secondary analysis included validated unit responses collected from September 2021 to January 2022. Survey domians including access to an intensive care unit (ICU), modified early-obstetric warning-score (MEOWS) use, availability of critical-care resources, care locations for pre-eclampsia, postpartum haemorrhage (PPH) and sepsis, and maternal/staff support by focusing service accessibility and annual delivery rate were used. The comparator comprised 993 non-Türkiye units, and 140 Turkish units from 1,133-unit MaCriCare cohort.
RESULTS: Responses from 140/403 eligible units (34.7%) represented 305,250 annual deliveries where 501-1,500 and 1,501-3,000 annual deliveries comprised 32.1% and 30.0%, respectively. Rate of same-hospital ICU access was 78.6% and 82.4% and use of any MEOWS system was 27.9% and versus 35.4% in Turkish vs non-Türkiye units, respectively. For pre-eclampsia, 58/140 units (41.4%) reported obstetric-unit care before delivery, followed by separate critical care particularly for PPH varied between 62.1% to 82.9%. Sepsis rate was 86.4%. Unavailable advanced resources included cardiac output monitoring (30.0%), cell salvage (47.1%), and viscoelastic testing (67.1%). Rate of breastfeeding support was 92.7% and maternal psychological screening was 24.5%.
CONCLUSIONS: Describing maternal critical-care infrastructure and reported organisational arrangements among participating Turkish units may support future service assessment and planning.