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1980 - 1986年坎帕拉五家医院孕产妇死亡率及原因

Incidence and causes of maternal mortality in five Kampala hospitals, 1980-1986.

作者信息

Kampikaho A, Irwig L M

机构信息

Institute of Public Health, Makerere University, Kampala, Uganda.

出版信息

East Afr Med J. 1991 Aug;68(8):624-31.

PMID:1765015
Abstract

This report presents results of a descriptive study to estimate the mortality rate, identify the type and the causes of maternal deaths. The study was conducted in 1987 in Kampala hospitals for a period covering seven years from 1st January 1980 to 31st December, 1986. The non abortion maternal mortality rate (NAMMR) was 2.65 per 1000 deliveries while the abortion related maternal mortality rate (ARMMR) was 3.58 per 1000 abortions. There was a statistically significant increase in NAMMR while the increase in ARMMR was almost significant over the seven year period. Of all maternal deaths, 80 per cent were non abortion while 20 per cent were abortion related. The commonest immediate causes of death, in order of importance, were sepsis, haemorrhage, ruptured uterus, anaesthesia and anaemia. The commonest patient management factors which contributed to death, in order of importance, were lack of blood for transfusion, lack of drugs and intravenous fluids, theatre problems and doctor related factors. We feel that a lot happens to the pregnant mother before she finally reaches a health unit for delivery and that there is a great need to improve on the community's gynaecological and obstetrical services as well as ambulance and emergency services. We also feel that maternal mortality in developing countries could be reduced if the health workers were imaginative in respect to each patient, tried not to operate as though they were working in a developed country, and created relevant solutions for the local problems.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本报告展示了一项描述性研究的结果,以估算死亡率,确定孕产妇死亡的类型和原因。该研究于1987年在坎帕拉的医院开展,时间跨度为1980年1月1日至1986年12月31日这七年。非流产孕产妇死亡率(NAMMR)为每1000例分娩2.65例,而与流产相关的孕产妇死亡率(ARMMR)为每1000例流产3.58例。在这七年期间,NAMMR有统计学显著上升,而ARMMR的上升几乎具有显著性。在所有孕产妇死亡中,80%为非流产相关死亡,20%为流产相关死亡。按重要性排序,最常见的直接死亡原因依次为败血症、出血、子宫破裂、麻醉和贫血。按重要性排序,导致死亡的最常见患者管理因素依次为缺乏输血用血、缺乏药物和静脉输液、手术室问题以及与医生相关的因素。我们认为,孕妇在最终到达医疗机构分娩之前经历了很多状况,非常有必要改善社区的妇产科服务以及救护车和急救服务。我们还认为,如果卫生工作者针对每位患者发挥想象力,不照搬在发达国家工作的模式,而是为当地问题创造相关解决方案,发展中国家的孕产妇死亡率是可以降低的。(摘要截选至250字)

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