Zhang Shumin, Qi Yalan, Xue Xiumei, Zhang Xiaojing, Cao Qingling, Fang Yuelan, Ge Mingming
Department of Obstetrics and Gynecology, Suqian Hospital of Nanjing Drum Tower Hospital Group The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian Critical Maternal Care Center in Suqian City Jiangsu Province China.
Health Sci Rep. 2021 Oct 14;4(4):e407. doi: 10.1002/hsr2.407. eCollection 2021 Dec.
Through a retrospective study of maternal near miss (MNM) cases treated by the Suqian Critical Maternal Care Center in Suqian City, Jiangsu Province, we summarized the most common diseases that caused MNM, treatment measures, and short-term prognosis in this region. The purpose of the research is to improve the clinical evidence of maternal health care in the region.
The study is a retrospective descriptive study. Among the pregnant women admitted to the Critical Maternal Care Center from 1 January 2015, to 31 December 2019, the pregnant women with severe pregnancy complications or comorbidities were identified as the research subjects. The study subjects were divided into an MNM group and a control group according to the MNM criteria recommended by the WHO.A retrospective analysis of the study subject data, including causes and clinical manifestations of MNM, treatment measures, and short-term prognosis, was conducted.
The total number of deliveries was 27 619. There were 145 women in the control group and 65 women in the MNM group. The number of MNM cases accounted for 2.4% (65/27619) of the total number of deliveries. Placenta previa, postpartum hemorrhage, and hypertension accounted for 72.3% (47/65) of the causes of MNM cases observed. In the MNM group, the most common clinical manifestation was bleeding (80.0%, 52/65). Sixty-three patients underwent massive blood transfusion (96.9%, 63/65), and 36 underwent hysterectomy (55.4%,36/65). The prevalence of interventional procedures and unplanned secondary operations in the MNM group was higher than that in the control group.
The top three causes of MNM were placenta previa, postpartum hemorrhage, and hypertension in pregnancy in Suqian area. Sufficient blood sources, convenient and fast blood transfusion procedures, and the use of large amounts of blood transfusion technology have an important impact on the success of treatment. Hysterectomy is still the main method of MNM treatment.
通过对江苏省宿迁市宿迁市危重症孕产妇救治中心救治的孕产妇险些死亡（MNM）病例进行回顾性研究，总结该地区导致MNM的最常见疾病、治疗措施及短期预后情况。研究目的是提高该地区孕产妇保健的临床证据。
本研究为回顾性描述性研究。在2015年1月1日至2019年12月31日入住危重症孕产妇救治中心的孕妇中，将患有严重妊娠并发症或合并症的孕妇确定为研究对象。根据世界卫生组织推荐的MNM标准，将研究对象分为MNM组和对照组。对研究对象的数据进行回顾性分析，包括MNM的病因、临床表现、治疗措施及短期预后。
分娩总数为27619例。对照组有145例妇女，MNM组有65例妇女。MNM病例数占分娩总数的2.4%（65/27619）。前置胎盘、产后出血和高血压占观察到的MNM病例病因的72.3%（47/65）。在MNM组中，最常见的临床表现是出血（80.0%，52/65）。63例患者接受了大量输血（96.9%，63/65），36例接受了子宫切除术（55.4%，36/65）。MNM组介入手术和非计划二次手术的发生率高于对照组。
宿迁地区MNM的前三位病因是前置胎盘、产后出血和妊娠期高血压。充足的血源、便捷快速的输血程序以及大量输血技术的应用对治疗成功具有重要影响。子宫切除术仍是MNM治疗的主要方法。
