UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria.
BJOG. 2019 Jun;126 Suppl 3:33-40. doi: 10.1111/1471-0528.15699. Epub 2019 May 3.
To investigate the prevalence of life-threatening complications related to pregnancies with abortive outcome and the associated health service events and performance in Nigerian public tertiary hospitals.
Secondary analysis of a nationwide cross-sectional study.
Forty-two tertiary hospitals.
Women admitted for pregnancy-related complications.
All cases of severe maternal outcomes (SMO: maternal near-miss or death) due to abortive pregnancy complications (defined as spontaneous or induced abortion, and ectopic pregnancy) were prospectively identified over 1 year using uniform identification criteria.
Prevalence of SMO, mortality index (% maternal death/SMO), case fatality rate, time until death after admission, and health service performance.
Of 5779 women admitted with abortive pregnancy complications, 444 (7.9%) experienced an SMO: 366 maternal near-misses and 78 maternal deaths. Intra-hospital maternal mortality ratio from complicated abortive pregnancy outcome was 85/100 000 live births. Case fatality rate was worst for abortion-related infections (19.1%). A quarter of maternal deaths occurred on the same day of admission; however, the peak time of occurrence of death was 3-7 days of admission. Women experiencing cardiovascular, renal or coagulation organ dysfunction were less likely to survive. Higher level of maternal education and closer residence to a health facility improved chance of maternal survival.
Abortive outcome remains a major contributor to SMO in Nigeria. Although early hospital presentation by women is critical to surviving abortive pregnancy complications, improved, appropriate, and timely management is essential to enhance maternal survival.
78 maternal deaths and 366 near-misses occurred from abortions and ectopic pregnancies in 42 Nigerian referral hospitals in 1 year.
调查与流产结局相关的危及生命的并发症的流行情况，以及尼日利亚公立三级医院相关的卫生服务事件和表现。
全国性横断面研究的二次分析。
42 家三级医院。
因妊娠相关并发症入院的妇女。
使用统一的识别标准，在 1 年内前瞻性识别所有因流产并发症（定义为自然流产或人工流产以及宫外孕）导致的严重孕产妇结局（孕产妇接近死亡或死亡）病例。
严重孕产妇结局（SMO：孕产妇接近死亡或死亡）的发生率、死亡率指数（%孕产妇死亡/SMO）、病死率、入院后死亡时间和卫生服务表现。
5779 例因流产相关并发症入院的妇女中，444 例（7.9%）发生 SMO：366 例孕产妇接近死亡，78 例孕产妇死亡。因复杂流产结局导致的院内孕产妇死亡率为 85/100000 活产儿。与流产相关感染的病死率最高（19.1%）。四分之一的孕产妇死亡发生在入院当天；然而，死亡的高峰时间是入院后 3-7 天。发生心血管、肾脏或凝血器官功能障碍的产妇存活的可能性较小。孕产妇受教育程度较高和居住地靠近医疗机构，可提高其存活的机会。
流产结局仍是尼日利亚 SMO 的主要原因。尽管妇女早期到医院就诊对存活流产并发症至关重要，但改善、适当和及时的管理对提高孕产妇的存活率至关重要。
