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苏丹女性中前置胎盘严重的孕妇的胎儿及母体结局:一项前瞻性横断面研究

Fetal and Maternal Outcomes in Women With Major Placenta Previa Among Sudanese Women: A Prospective Cross-Sectional Study.

作者信息

Alsammani Mohamed Alkhatim, Nasralla Khalid

机构信息

Department of Obstetrics and Gynecology, College of Medicine, Qassim University, Buraidah, SAU.

Department of Obstetrics and Gynecology, College of Medicine, University of Bahri, Khartoum, SDN.

出版信息

Cureus. 2021 Apr 13;13(4):e14467. doi: 10.7759/cureus.14467.

Abstract

Background Placenta previa is a major obstetric problem with high rates of fetomaternal mortality and morbidity. This study aimed to determine the prevalence and fetal and maternal outcomes of major degree placenta previa among Sudanese women. Method This is a prospective descriptive study conducted in the period from January 1 to June 30, 2109, at Omdurman Maternity Hospital, Khartoum, Sudan. Fetal and maternal complications associated with major degree placenta were analyzed using descriptive statistics. Results The total number of deliveries was 22,000, of which 87 cases were of major degree placenta previa, giving a prevalence rate of 0.4%, the hysterectomies rate was 23% (n= 20), and the total maternal deaths were 6.9% (n= 6). Intraoperative interventions used to control the bleeding were multiple hemostatic sutures in 34.5% (n=30) of cases, followed by uterine backing (20.7%; n= 18), and uterine artery ligation (12.6%; n=11). The common reported maternal complications were bladder injuries (28.7%; n= 25) followed by bowel injuries (4.6%; n=5). Of all mothers, 48.27% (n=42) were admitted to the intensive care unit (ICU). Of all deliveries, 26.4% (n=23) were preterm, and 38% (n=33) of neonates were admitted to the newborn intensive care unit (NICU), and 9.2% (n=8) were fresh stillbirth (FSB). Conclusion Neonatal complications were comparable to other studies but maternal deaths were relatively high. The study indicated the need for effective management protocols and more training of the medical staff in order to overcome the problem.

摘要

背景

前置胎盘是一个主要的产科问题,母婴死亡率和发病率很高。本研究旨在确定苏丹女性中重度前置胎盘的患病率以及母婴结局。方法:这是一项前瞻性描述性研究,于2019年1月1日至6月30日在苏丹喀土穆的恩图曼妇产医院进行。对与重度前置胎盘相关的母婴并发症进行描述性统计分析。结果:分娩总数为22000例,其中重度前置胎盘87例,患病率为0.4%,子宫切除率为23%(n = 20),孕产妇总死亡率为6.9%(n = 6)。术中用于控制出血的干预措施包括:34.5%(n = 30)的病例采用多处止血缝合,其次是子宫压迫(20.7%;n = 18)和子宫动脉结扎(12.6%;n = 11)。常见的孕产妇并发症报告为膀胱损伤(28.7%;n = 25),其次是肠损伤(4.6%;n = 5)。所有母亲中,48.27%(n = 42)入住重症监护病房(ICU)。所有分娩中,26.4%(n = 23)为早产,38%(n = 33)的新生儿入住新生儿重症监护病房(NICU),9.2%(n = 8)为新鲜死产(FSB)。结论:新生儿并发症与其他研究相当,但孕产妇死亡相对较高。该研究表明需要有效的管理方案和对医务人员进行更多培训以克服该问题。

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