Nair Manisha, Choudhury Manoj K, Choudhury Saswati S, Kakoty Swapna D, Sarma Umesh C, Webster Premila, Knight Marian
National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Srimanta Sankaradeva University of Health Sciences, Guwahati, Assam, India.
BMJ Glob Health. 2016 Apr 7;1(1):e000024. doi: 10.1136/bmjgh-2015-000024. eCollection 2016.
To assess the feasibility of establishing a simple maternal morbidity surveillance system in Assam (Indian Obstetric Surveillance System-Assam (IndOSS-Assam)) to investigate the incidence and trends in severe maternal complications. This study presents the surveillance platform of IndOSS-Assam.
Four tasks were undertaken: (1) setting up of a steering committee; (2) establishing priorities for the region; (3) mapping of surveillance sites; (4) piloting case-notification systems in selected centres.
Two government tertiary hospitals in the state.
Pregnant women delivering in the hospitals between March and August 2015.
Incidence and case fatality rates with 95% CIs.
Local stakeholder ownership and a simple uncomplicated anonymous system for case notification were the key strengths of this project. Cases and deaths were reported for six conditions: eclampsia, postpartum haemorrhage, puerperal sepsis, septic abortion, uterine rupture and anaemic heart failure. Among 10 475 women delivering over 6 months, 402 had one of these conditions and 66 died (case fatality 16%). The incidence of eclampsia was 17 per 1000 deliveries (95% CI 14 to 19), postpartum haemorrhage was 11 per 1000 deliveries (95% CI 10 to 13) and anaemic heart failure was 3 per 1000 deliveries (95% CI 2 to 5). For each of the other three conditions-puerperal sepsis, septic abortion and uterine rupture-the incidence rate was 2 per 1000 deliveries.
IndOSS-Assam was shown to be a feasible and simple system for ongoing surveillance of maternal morbidity that can be used to monitor the trends in the incidence of specific severe life-threatening conditions during pregnancy.
评估在阿萨姆邦建立一个简单的孕产妇发病监测系统（印度产科监测系统 - 阿萨姆邦（IndOSS - 阿萨姆邦））以调查严重孕产妇并发症的发病率和趋势的可行性。本研究介绍了IndOSS - 阿萨姆邦的监测平台。
开展了四项任务：（1）设立指导委员会；（2）确定该地区的优先事项；（3）绘制监测地点；（4）在选定中心试行病例报告系统。
该邦的两家政府三级医院。
2015年3月至8月在医院分娩的孕妇。
发病率和病死率及95%可信区间。
当地利益相关者的参与以及一个简单、不复杂的匿名病例报告系统是该项目的关键优势。报告了六种情况的病例和死亡：子痫、产后出血、产褥感染、感染性流产、子宫破裂和贫血性心力衰竭。在6个月内分娩的10475名妇女中，402人患有这些疾病之一，66人死亡（病死率16%）。子痫的发病率为每1000例分娩17例（95%可信区间14至19），产后出血为每1000例分娩11例（95%可信区间10至13），贫血性心力衰竭为每1000例分娩3例（95%可信区间2至5）。对于其他三种情况——产褥感染、感染性流产和子宫破裂——发病率均为每1000例分娩2例。
IndOSS - 阿萨姆邦被证明是一个可行且简单的持续监测孕产妇发病情况的系统，可用于监测孕期特定严重危及生命疾病的发病率趋势。
