Zishiri C, Shodu L K, Tshimanga M, Nyirongo L
Ministry of Health and Child Welfare, Harare, Zimbabwe.
Cent Afr J Med. 1999 Sep;45(9):234-9. doi: 10.4314/cajm.v45i9.8491.
To determine morbid conditions suffered by mothers during the first six weeks post delivery and risk factors associated with them in Gweru district.
A cross sectional survey.
Gweru district hospital, Monomotapa, Mkoba 1 and Mkoba polyclinic.
A consecutive sample of 201 mothers residing in Gweru district who delivered in these facilities during the month of June 1997.
Morbid conditions, magnitude and the risk factors.
During follow up checks on recruited mothers, turn up rates were 82% and 63% at two and six weeks respectively. Fifty eight percent (58%) of the mothers reported at least one morbid condition within the first 24 hours post delivery and pain was a dominant feature. At two weeks, 56% of those who turned up predominantly presented with sepsis in areas of the reproductive tract. The figure fell to 35% among mothers who turned up at six weeks and a mixture of pain and sepsis were the predominant complaints. Episiotomies caused a lot of pain post operatively and the risk of subsequent sepsis was high, (OR: 9; 95% CI: 1.16 < OR < 69.7; p = 0.020). Statistically significant associations were found between backache and multiparity (OR: 1.89; 95% CI: 1 < OR < 3.4; p = 0.040) and also between Caesarian section and some morbid conditions (OR: 4.14; p = 0.002; 95% CI 2.05 < OR < 10.91). The prevalence rate of HIV was 29.4%. HIV positivity was associated with marriage below the age of 19 years (OR: 2.4; 95% CI 1.21 < OR < 3.8; p = 0.024). There was no association between HIV serostatus and maternal morbidity. Use of traditional medication during pregnancy was reported by 42% of mothers, but it did not have any immediately observable intrapartum of post partum effects. Similarly the place of delivery was not associated with post natal maternal morbidity.
The first two weeks post delivery were the most critical for the mother in terms of post natal maternal morbidity. Sepsis associated pain was the predominant condition. To improve the effectiveness of post natal care, a review within the first two weeks post delivery is an essential intervention, in addition to the routine six weeks check.
确定格韦鲁地区产后六周内母亲所患疾病及其相关危险因素。
横断面调查。
格韦鲁地区医院、莫诺莫塔帕、姆科巴1号和姆科巴综合诊所。
1997年6月在这些机构分娩的连续抽样的201名居住在格韦鲁地区的母亲。
疾病情况、严重程度及危险因素。
在对招募的母亲进行随访检查时，两周和六周时的到诊率分别为82%和63%。58%的母亲在产后24小时内报告至少有一种疾病，疼痛是主要特征。两周时，到诊的母亲中有56%主要表现为生殖道感染。六周时到诊的母亲中这一比例降至35%，主要抱怨为疼痛和感染。会阴切开术后疼痛剧烈，随后发生感染的风险很高（比值比：9；95%置信区间：1.16＜比值比＜69.7；p = 0.020）。发现背痛与多胎妊娠之间存在统计学显著关联（比值比：1.89；95%置信区间：1＜比值比＜3.4；p = 0.040），剖宫产与某些疾病之间也存在关联（比值比：4.14；p = 0.002；95%置信区间2.05＜比值比＜10.91）。艾滋病毒感染率为29.4%。艾滋病毒阳性与19岁以下结婚有关（比值比：2.4；95%置信区间1.21＜比值比＜3.8；p = 0.024）。艾滋病毒血清状态与孕产妇发病率之间无关联。42%的母亲报告在孕期使用过传统药物，但未观察到对分娩期或产后有任何直接影响。同样，分娩地点与产后孕产妇发病率无关。
就产后孕产妇发病率而言，产后两周对母亲最为关键。与感染相关的疼痛是主要病症。为提高产后护理的有效性，除了常规的六周检查外，产后两周内进行复查是一项必要的干预措施。
