Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, California, United States of America.
PLoS One. 2013 Aug 8;8(8):e70446. doi: 10.1371/journal.pone.0070446. eCollection 2013.
The Non-Pneumatic Anti-Shock Garment (NASG) is a first-aid device to reduce mortality from severe obstetric hemorrhage, the leading cause of maternal mortality globally. We sought to evaluate patient characteristics associated with mortality among a cohort of women treated with the NASG in Nigeria. Data on 1,149 women were collected from 50 facilities participating in the Pathfinder International Continuum of Care: Addressing Postpartum Hemorrhage project in Nigeria from 2007-2012. Characteristics were compared using the appropriate distributional tests, and we estimated multivariable logistic regression models to control for treatment received. There were 201 deaths (17.5%). Women who died were significantly more likely to have any co-morbidity (AOR 3.63, 95% CI: 2.41-5.48), ruptured uterus (AOR 2.79, 95% CI: 1.48-5.28), macerated stillbirth (AOR 2.96, 95% CI 1.60-5.48) and to have had 6 or more previous births, (AOR 1.53, 95% CI 1.11-2.12), after adjusting for treatment received. These results suggest certain maternal conditions, particularly the presence of another life-threatening co-morbidity or macerated stillbirth, conferred a higher risk of mortality from PPH. This underscores the need for multi-system assessment and a comprehensive approach to the treatment of women with pregnancy complications.
非充气式抗休克服(NASG)是一种急救设备,可降低全球孕产妇死亡的主要原因——严重产后出血导致的死亡率。我们旨在评估在尼日利亚接受 NASG 治疗的女性队列中与死亡率相关的患者特征。2007 年至 2012 年期间,来自参与探索国际持续关怀:解决产后出血项目的 50 个机构的数据共收集了 1149 名妇女。使用适当的分布检验比较特征,并估计多变量逻辑回归模型来控制接受的治疗。有 201 人死亡(17.5%)。死亡的女性更有可能患有任何合并症(AOR 3.63,95%CI:2.41-5.48)、子宫破裂(AOR 2.79,95%CI:1.48-5.28)、胎死宫内(AOR 2.96,95%CI 1.60-5.48),且生育次数超过 6 次(AOR 1.53,95%CI 1.11-2.12),在调整了接受的治疗后。这些结果表明,某些产妇状况,特别是存在另一种危及生命的合并症或胎死宫内,会增加 PPH 的死亡率风险。这突显了对妊娠并发症妇女进行多系统评估和综合治疗的必要性。