Strand R T, Tumba P, Niekowal J, Bergström S
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Afr J Reprod Health. 2010 Jun;14(2):55-62.
Audit of uterine rupture (UR) used as a process indicator, can identify factors considered avoidable to improve future quality of obstetric care. Records of UR cases at a referral maternity in Luanda were studied retrospectively (n=43) and prospectively (n=67) including basic obstetric information, maternal and foetal outcome, duration of labour, time interval between diagnosis and intervention, drugs used, type of delivery and intervention, surgical procedures and complications. A clinical estimation of avoidability was based on this information. Prevalence of UR was 4.9%. Maternal case fatality rate was 14% and early perinatal mortality 71%. Women with previous Caesarean Section (CS) constituted 28%, grand multiparous women 44% and primiparous women 6%. Uterotonic treatment was given in 36%. Avoidability was estimated to 65%. Regular morbidity-oriented audits with analysis of clinical management reveal weaknesses in obstetric care and may serve as an instrument for future improvement.
将子宫破裂（UR）作为一项过程指标进行审计，可以识别出被认为是可避免的因素，以提高未来产科护理的质量。对罗安达一家转诊产科的子宫破裂病例记录进行了回顾性研究（n = 43）和前瞻性研究（n = 67），包括基本产科信息、母婴结局、产程、诊断与干预之间的时间间隔、所用药物、分娩和干预类型、手术程序及并发症。基于这些信息对可避免性进行了临床评估。子宫破裂的患病率为4.9%。孕产妇病死率为14%，早期围产儿死亡率为71%。有剖宫产史的女性占28%，经产妇占44%，初产妇占6%。36%的患者接受了宫缩剂治疗。可避免性估计为65%。定期开展以发病率为导向的审计并分析临床管理情况，可揭示产科护理中的薄弱环节，并可作为未来改进的一种手段。
