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2016年埃塞俄比亚提格雷西北部希雷镇苏胡勒综合医院子宫破裂的相关因素与结局:一项病例对照研究

Associated Factors and Outcome of Uterine Rupture at Suhul General Hospital, Shire Town, North West Tigray, Ethiopia 2016: A Case-Control Study.

作者信息

Marie Bereka Tefera, Mulat Aweke Amlaku, Eshetie Wondie Tewodrose

机构信息

Midwifery Department, Debre Markos University, College of Medicine and Health Science, Debre Markos, Ethiopia.

Midwifery Department, Bahir Dar University, College of Medicine and Health Sciences, Bahirdar, Ethiopia.

出版信息

Obstet Gynecol Int. 2017;2017:8272786. doi: 10.1155/2017/8272786. Epub 2017 Dec 18.

Abstract

BACKGROUND

Uterine rupture is tearing of the uterine wall during pregnancy or delivery. It may extend to partial or whole thickness of the uterine wall. It is usually a case where obstetric care is poor. In extensive damage, death of the baby and sometimes even maternal death are evident.

OBJECTIVE

This study assesses associated factors and outcome of uterine rupture at Suhul General Hospital, Tigray Region, Ethiopia, 2016.

METHODOLOGY

A case-control study was conducted by review of data from September 2012 to August 2016. A total of 336 samples were studied after calculating by EPI-INFO using proportion of multiparity (53%) and ratio of 1 : 2 for cases and controls, respectively. Analysis was done using SPSS version 20. Bivariate and multivariate logistic regression was applied with < 0.05.

RESULT

ANC, grand multiparity, malpresentation, and obstructed labor had association, but previous cesarean delivery was not significant. Perinatal mortality was 105 (93%) versus 13 (5.8%) in cases and controls, respectively. Anemia was highest for both groups (53.7% versus 32.1%).

CONCLUSION

Majority of uterine rupture is attributed to prolonged or obstructed labor. Cases of uterine rupture had prompt management preventing maternal mortality, but burden of perinatal death is still high.

摘要

背景

子宫破裂是指在妊娠或分娩期间子宫壁的撕裂。它可能延伸至子宫壁的部分或全层厚度。这通常是产科护理不佳的情况。在广泛损伤时,胎儿死亡甚至有时产妇死亡都很明显。

目的

本研究评估2016年埃塞俄比亚提格雷地区苏胡尔综合医院子宫破裂的相关因素及结局。

方法

通过回顾2012年9月至2016年8月的数据进行病例对照研究。在使用EPI-INFO根据多胎比例(53%)并分别按病例与对照1:2的比例计算后,共研究了336个样本。使用SPSS 20版进行分析。应用二元和多元逻辑回归,P<0.05。

结果

产前检查、多胎妊娠、胎位异常和产程梗阻存在关联,但既往剖宫产无显著关联。病例组围产儿死亡率为105例(93%),对照组为13例(5.8%)。两组贫血发生率均最高(分别为53.7%和32.1%)。

结论

大多数子宫破裂归因于产程延长或产程梗阻。子宫破裂病例得到了及时处理,预防了产妇死亡,但围产儿死亡负担仍然很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52cc/5748301/3e5f834392f5/OGI2017-8272786.001.jpg

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