Ahadi Sayed Shir Mohammad, Yoshida Yoshitoku, Rabi Mirwais, Sarker Mohammad Abul Bashar, Reyer Joshua A, Hamajima Nobuyuki
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan ; Department of Obstetrics/Gynecologic, Balkh regional hospital, Ministry of public health, Islamic Republic of Afghanistan.
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2015 Feb;77(1-2):103-11.
In Afghanistan, preeclampsia/eclampsia is the second leading cause of maternal deaths following maternal hemorrhage. This study aimed to describe clinical features, current treatments, and outcome among preeclampsia and eclampsia patients in the north region of Afghanistan. This was a retrospective study based on medical records of four center hospitals (one regional hospital and three provincial hospitals) in the north region of Afghanistan. Subjects were 322 patients with preeclampsia/eclampsia, admitted from March 2012 to March 2013. Out of 322 cases, 72.7% were diagnosed as preeclampsia and the rest as eclampsia. Those aged 30-39 years were 41.0% among preeclampsia patients and 29 years and younger were 35.2% among eclampsia patients (p= 0.002). The first delivery was significantly higher (p=0.045) among eclampsia patients (51.1%) than among preeclampsia patients (36.8%). While none died among the preeclampsia patients, 12 out of 88 eclampsia patients died in the hospitals. The causes of the 12 deaths were pulmonary edema (6 patients), renal failure (3 patients), cerebrovascular attack (2 patients), and hemorrhage (1 patient). There were no clinical findings at admission significantly associated with the deaths within the eclampsia patient group. Although the sample size was not large enough, patients admitted to the regional/provincial hospitals at the stage of preeclampsia had a low risk of death. Access at the stage of preeclampsia and improvement in treatments for eclampsia would reduce maternal mortality in Afghanistan.
在阿富汗，先兆子痫/子痫是仅次于孕产妇出血的第二大孕产妇死亡原因。本研究旨在描述阿富汗北部地区先兆子痫和子痫患者的临床特征、当前治疗方法及治疗结果。这是一项基于阿富汗北部地区四家中心医院（一家地区医院和三家省级医院）病历的回顾性研究。研究对象为2012年3月至2013年3月收治的322例先兆子痫/子痫患者。在322例病例中，72.7%被诊断为先兆子痫，其余为子痫。先兆子痫患者中30 - 39岁的占41.0%，子痫患者中29岁及以下的占35.2%（p = 0.002）。子痫患者的初产比例（51.1%）显著高于先兆子痫患者（36.8%）（p = 0.045）。先兆子痫患者中无死亡病例，88例子痫患者中有12例在医院死亡。12例死亡原因分别为肺水肿（6例）、肾衰竭（3例）、脑血管意外（2例）和出血（1例）。子痫患者组内入院时的临床表现与死亡无显著相关性。尽管样本量不够大，但先兆子痫阶段入住地区/省级医院的患者死亡风险较低。在先兆子痫阶段获得救治以及改善子痫的治疗方法将降低阿富汗的孕产妇死亡率。
