Department of Gynecology and Obstetrics, Maasstad Ziekenhuis, Rotterdam, Netherlands.
Int J Gynaecol Obstet. 2013 Jan;120(1):74-7. doi: 10.1016/j.ijgo.2012.07.028. Epub 2012 Nov 24.
To analyze maternal deaths at Nkhoma Church of Central Africa Presbyterian (CCAP) Hospital and identify factors causing delays in care.
Maternal death audits are performed after every maternal death at Nkhoma CCAP Hospital. Information regarding the care provided at the health facility, the referral process, and any delays in the community was collected by an audit team using a structured approach. Data from August 2007 to September 2011 were analyzed retrospectively.
In total, 61 maternal deaths occurred during the study period, of which 58 were analyzed. Most deaths were categorized as indirect (n=34 [58.6%]). Non-pregnancy-related infections were the leading cause of indirect death (n=22), with meningitis the most common (n=13). Most patients experienced a delay in seeking care (n=37 [63.8%]), a transport delay (n=43 [74.1%]), or a delay in receiving adequate care (n=34 [58.6%]).
Most maternal deaths had indirect causes and were associated with delays in all phases. An audit makes clear which part of the referral chain needs to be strengthened. Nkhoma CCAP Hospital has taken steps to address all phases of delay.
分析中非长老会 Nkhoma 教会医院（CCAP）产妇死亡病例，确定导致护理延误的因素。
在 Nkhoma CCAP 医院每发生一例产妇死亡后，都会进行产妇死亡审核。审核团队采用结构化方法收集有关在医疗机构中提供的护理、转诊流程以及社区中任何延误的信息。对 2007 年 8 月至 2011 年 9 月的数据进行回顾性分析。
在研究期间，共有 61 例产妇死亡，其中 58 例进行了分析。大多数死亡被归类为间接性（n=34[58.6%]）。非妊娠相关感染是间接性死亡的主要原因（n=22），其中脑膜炎最常见（n=13）。大多数患者在寻求护理方面存在延误（n=37[63.8%]）、转运延误（n=43[74.1%]）或接受充分护理的延误（n=34[58.6%]）。
大多数产妇死亡的间接原因与所有阶段的延误有关。审核明确了需要加强的转诊链的哪一部分。Nkhoma CCAP 医院已采取措施解决所有延误阶段的问题。
