Nekkanti Ankita C, Hazra Darpanarayan, George Reshma M, Yalamanchili Sruthi, Kumari Pushpalata, Samuel Santosh T, Abhilash Kundavaram P P
Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Internship Student, Christian Medical College, Vellore, Tamil Nadu, India.
J Family Med Prim Care. 2020 Sep 30;9(9):4618-4622. doi: 10.4103/jfmpc.jfmpc_713_20. eCollection 2020 Sep.
National efforts to reduce maternal mortality with respect to community services have primarily focused on upgrading transportation infrastructure and formalizing training for care providers. There is, however, a paucity of baseline data on the profile and outcomes of pregnant women presenting to the Emergency Department (ED) in India.
This retrospective study enrolled all pregnant women presenting to a large tertiary medical care center in India, between November 2016 and November 2017.
There were 696 ED visits by pregnant women during the study period. The mean age was 26.85 (SD: 4.88) years. Pregnant women in the first trimester contributed to 50.8% of all visits, and 54% being multigravida. The most common presenting complaints were bleeding/spotting per vaginum (PV) (38.2%) and abdominal pain (37.6%) followed by fever (21.6%) and vomiting (21.5%). Obstetric causes contributed to 53.2% of the ED visits, while nonobstetric causes amounted to 43.2%. Over a third (39.7%) required hospital admission. Of these patients, 73% delivered in CMC with live births amounting to 62.3% while 3.5% ended in fetal deaths. The miscarriages rate was as high as 28%. More than half (51.1%) of the deliveries were by normal vaginal delivery. There were no maternal deaths during the time of admission.
Our study sheds new light on the profile of emergency visits among pregnant patients and their relationship to the outcome of pregnancy. First trimester visits were most common with complaints of bleeding PV and abdominal pain. This could explain the high rate of miscarriages among this population.
国家在社区服务方面为降低孕产妇死亡率所做的努力主要集中在改善交通基础设施以及规范护理人员培训上。然而，关于印度急诊科收治的孕妇的基本情况和结局的基线数据却很匮乏。
这项回顾性研究纳入了2016年11月至2017年11月期间前往印度一家大型三级医疗中心就诊的所有孕妇。
在研究期间，孕妇到急诊科就诊696次。平均年龄为26.85岁（标准差：4.88）。孕早期孕妇占所有就诊人数的50.8%，其中54%为经产妇。最常见的就诊主诉是阴道出血/点滴出血（38.2%）和腹痛（37.6%），其次是发热（21.6%）和呕吐（21.5%）。产科原因导致的急诊科就诊占53.2%，而非产科原因占43.2%。超过三分之一（39.7%）的患者需要住院治疗。在这些患者中，73%在基督教医学中心分娩，活产率为62.3%，而胎儿死亡占3.5%。流产率高达28%。超过一半（51.1%）的分娩是正常阴道分娩。住院期间无孕产妇死亡。
我们的研究为孕妇急诊就诊情况及其与妊娠结局的关系提供了新的线索。孕早期就诊最为常见，主诉为阴道出血和腹痛。这可能解释了该人群中流产率较高的原因。
