Ukachukwu V E, Unger H, Onoka C, Nduka C, Maina S, Ngugi N
Department of Paediatrics, National Hospital for Women and Children, Abuja, Nigeria.
East Afr J Public Health. 2009 Aug;6(2):112-8.
Improving quality of maternal healthcare delivery is pivotal to reversing the trend of maternal health in developing countries and consequently, achieving the 5th millennium goal of reducing maternal mortality and improving universal access to reproductive health. Periodic facility-based reviews of maternal morbidity and mortality are crucial to improving quality of care delivered.
This retrospective study was conducted in PCEA Kikuyu Hospital, Kenya. Data on sociodemographics, recorded antenatal care activities, maternal morbidities and deaths were elicited from case notes of all pregnancies and births over a 2 year period and subsequently analyzed.
There were 1716 deliveries during the period. 1405 (91%) of the women booked for antenatal care; 1068 (57.3%) had at least 3 visits before delivery. 842 (45.9%) were either untested for Human Immunodeficiency Virus or their results were not documented; 55 (3%) tested positive. The caesarean section rate was 27.4% (n=470); PMTCT (Prevention of Mother to Child Transmission) constituted 1.6% (10) of the indications. Urinary tract infection was the commonest maternal illness in pregnancy (14.5%, n=270), however, it was not found to be associated with any adverse outcome. Genital tract trauma was the commonest morbidity suffered by the women during delivery (90.6%, n=800). Psychological disorders constituted 5.3% (7) of reported postpartum complications. There were 2 maternal deaths out of 1673 live births, giving a maternal mortality ratio of 119.55 per 100,000 live births. The deaths resulted from septic abortion and eclampsia.
Urinary tract infection is an important cause of maternal illness during pregnancy. Routine screening is recommended. PMTCT needs further consolidation to increase the number of screened women and ensure those who need interventions like caesarean sections get access to them. Diagnosis and management of psychological disorders in pregnancy remain unsatisfactory. Further studies to identify the true burden of these conditions are needed.
提高孕产妇医疗服务质量对于扭转发展中国家孕产妇健康趋势至关重要，从而实现千年发展目标的第五个目标，即降低孕产妇死亡率并改善生殖健康的普及程度。定期对医疗机构进行孕产妇发病率和死亡率评估对于提高所提供的医疗服务质量至关重要。
这项回顾性研究在肯尼亚基库尤长老会医院进行。从2年期间所有怀孕和分娩的病历中获取社会人口统计学数据、记录的产前护理活动、孕产妇发病率和死亡情况，随后进行分析。
在此期间共有1716例分娩。1405名（91%）妇女预约了产前护理；1068名（57.3%）在分娩前至少就诊3次。842名（45.9%）妇女未进行人类免疫缺陷病毒检测或检测结果未记录；55名（3%）检测呈阳性。剖宫产率为27.4%（n = 470）；预防母婴传播（PMTCT）占手术指征的1.6%（10例）。尿路感染是孕期最常见的孕产妇疾病（14.5%，n = 270），然而，未发现其与任何不良结局相关。生殖道创伤是妇女分娩期间最常见的发病情况（90.6%，n = 800）。心理障碍占报告的产后并发症的5.3%（7例）。在1673例活产中有2例孕产妇死亡，孕产妇死亡率为每10万活产119.55例。死亡原因是感染性流产和子痫。
尿路感染是孕期孕产妇疾病的一个重要原因。建议进行常规筛查。预防母婴传播需要进一步巩固，以增加接受筛查的妇女数量，并确保那些需要剖宫产等干预措施的妇女能够获得这些服务。孕期心理障碍的诊断和管理仍不尽人意。需要进一步研究以确定这些情况的真实负担。
Zotero 插件