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在产后出血无法控制的女性中使用避孕套子宫球囊填塞套件后的休克进展及生存率

Shock progression and survival after use of a condom uterine balloon tamponade package in women with uncontrolled postpartum hemorrhage.

作者信息

Burke Thomas F, Danso-Bamfo Sandra, Guha Moytrayee, Oguttu Monica, Tarimo Vincent, Nelson Brett D

机构信息

Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.

Harvard Medical School, Boston, MA, USA.

出版信息

Int J Gynaecol Obstet. 2017 Oct;139(1):34-38. doi: 10.1002/ijgo.12251. Epub 2017 Jul 21.

Abstract

OBJECTIVE

To examine the outcomes of women in advanced shock from uncontrolled postpartum hemorrhage (PPH) who underwent placement of an Every Second Matters for Mothers and Babies Uterine Balloon Tamponade (ESM-UBT) device.

METHODS

In a prospective case series, data were collected for women who received an ESM-UBT device at healthcare facilities in Kenya, Senegal, Sierra Leone, and Tanzania between September 1, 2012, and September 30, 2016. Shock class was assigned on the basis of recorded blood pressures and mental status at the time of UBT placement.

RESULTS

Data for 306 women with uncontrolled PPH from uterine atony across 117 facilities were analyzed. Normal vital signs or class I/II shock were reported for 166 (54.2%). In this group, one death occurred and was attributed to PPH (survival rate 99.4%). There were no cases of shock progression. One hundred and eleven (36.3%) were in class III shock and 29 (9.5%) in class IV shock; the respective survival rates were 97.3% (n=108) and 86.2% (n=25).

CONCLUSION

The ESM-UBT device arrests hemorrhage, prevents shock progression, and is associated with high survival rates among women with uncontrolled PPH from uterine atony.

摘要

目的

研究因产后出血(PPH)无法控制而处于重度休克状态的女性接受母婴紧急子宫球囊压迫(ESM-UBT)装置置入后的结局。

方法

在一项前瞻性病例系列研究中,收集了2012年9月1日至2016年9月30日期间在肯尼亚、塞内加尔、塞拉利昂和坦桑尼亚的医疗机构接受ESM-UBT装置的女性的数据。根据置入UBT时记录的血压和精神状态确定休克分级。

结果

分析了来自117个机构的306例因宫缩乏力导致PPH无法控制的女性的数据。报告生命体征正常或处于I/II级休克的有166例(54.2%)。在该组中,发生1例死亡,归因于PPH(生存率99.4%)。没有休克进展的病例。111例(36.3%)处于III级休克,29例(9.5%)处于IV级休克;各自的生存率分别为97.3%(n=108)和86.2%(n=25)。

结论

ESM-UBT装置可止血,防止休克进展,并且与因宫缩乏力导致PPH无法控制的女性的高生存率相关。

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