分析金沙萨参考综合医院收治的与人工流产相关并发症的妇女：一家三级卫生机构，刚果民主共和国。

Analysis of induced abortion-related complications in women admitted to the Kinshasa reference general hospital: a tertiary health facility, Democratic Republic of the Congo.

机构信息

Community Health Department, Kinshasa School of Public Health, University of Kinshasa, PO Box11850, Kinshasa, Democratic Republic of Congo.

Research Centre "Policies and Health Systems - International Health", School of Public Health, Université libre de Bruxelles (ULB), Brussel, Belgium.

出版信息

Reprod Health. 2018 Jul 6;15(1):123. doi: 10.1186/s12978-018-0563-y.

DOI:10.1186/s12978-018-0563-y

PMID:29980213

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6035432/

Abstract

BACKGROUND

Due to a lack of relevant data on induced abortions in the Democratic Republic of the Congo (DRC) as well as the persistence of maternal deaths in the country, this study aims to analyse the induced abortion-related complications in women who were admitted to the Kinshasa Reference General Hospital (KRGH).

METHODS

This is a cross-sectional study on 368 obstetric and gynecological patients who were admitted, as emergency cases, to the KRGH during 2014. This health facility was selected because it is a tertiary health facility with an obstetric and gynecological emergency unit most used in the city of Kinshasa. Patient data were collected from patient records and analyzed.

RESULTS

From the 368 patients admitted to receive obstetric and gynecological emergency care services in 2014 at the KRGH, 12.2% (95% CI: 9.1-16.1%) had complications due to induced abortion that was significantly diagnosed to adolescents (p < 0.001), single or separated or divorced women or widow(p < 0.001), and to patients with history of one or several induced abortions(p < 0.001). The median duration of hospitalization was ten days and this period of time was significantly longer for the patients who underwent surgery for pelvic peritonitis due to uterine perforation(p < 0.001) compared with the group of patients who underwent Caesarean section/hysterectomy. The mortality rate related to them is 37.8% (95% CI: 23.8-53.5%) with an increase of risk of death in the presence of a post-abortive pelvic peritonitis-type complication, 56.3% of deaths occurred after two days of hospitalization.

CONCLUSION

The complications of induced abortions are a major public health problem due to its frequency among patients admitted to the KRGH, as well as the poor medical management, and mortality percentage related to them. Therefore, there is a need to understand the reason for the poor medical management to fill in and provide an adequate intervention package.

摘要

背景

由于刚果民主共和国（DRC）缺乏关于人工流产的相关数据，以及该国仍存在孕产妇死亡的情况，因此本研究旨在分析在金沙萨参考总医院（KRGH）接受治疗的因人工流产而导致并发症的女性。

方法

这是一项对 2014 年因紧急情况在 KRGH 接受妇产科治疗的 368 名患者进行的横断面研究。选择该医疗中心是因为它是一家三级医疗机构，设有妇产科急救科，是金沙萨市最常使用的科室。从患者病历中收集患者数据并进行分析。

结果

在 2014 年因妇产科紧急情况在 KRGH 接受治疗的 368 名患者中，有 12.2%（95%CI：9.1-16.1%）因人工流产而出现并发症，这在明显是青少年患者中诊断出（p<0.001），单身或离异或丧偶妇女或寡妇（p<0.001），以及有过一次或多次人工流产史的患者（p<0.001）。中位住院时间为 10 天，因子宫穿孔导致盆腹腔脓肿而行手术治疗的患者住院时间明显长于行剖宫产/子宫切除术的患者（p<0.001）。与这些并发症相关的死亡率为 37.8%（95%CI：23.8-53.5%），有流产后盆腹腔脓肿型并发症的患者死亡风险增加 56.3%，死亡发生在住院后两天。