Thakur Geetika, Arora Aashima, Sikka Pooja, Jain Vanita
Dept. of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
Clin Epidemiol Glob Health. 2022 Sep-Oct;17:101121. doi: 10.1016/j.cegh.2022.101121. Epub 2022 Aug 6.
Covid 19 pandemic has taken the world by storm. As far as maternal health is concerned, it has been affected both directly and indirectly. Not only are the women getting affected by COVID disease but also the health services are suffering in terms of availability, approachability and access. The study aimed to analyze the change in the trends of maternal near and maternal mortality comprising severe maternal outcome (SMO) between 2019 and 2020 in the department of obstetrics and gynaecology of our hospital due to COVID pandemic.
This retrospective study was conducted in the Obstetrics and Gynaecology department of Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. The maternal death review data and maternal near miss statistics were analysed. This included assessing the change in the number of maternal deaths and obstetric near miss, their respective causes, and case fatality rate specific to COVID during pregnancy.
The total births decreased from 6056 in 2019-4140 in 2020 whereas women with severe maternal outcomes increased from 4.6% in 2019 to 6.5% in 2020(p value < 0.001). The incidence of nearmiss increased significantly from 3.5% in 2019 to 5.1% in 2020(p value < 0.0001) and maternal mortality ratio increased from 1122 per 1 lakh births to 1425 per 1 lakh births. Haemorrhage was the most common cause of maternal near miss with 45.8% in 2019 and an increase to 50.2% in 2020. The percentage of illiterate patients with near miss statistically reduced in 2020(p value - 0.004). Average hospital stay also reduced from 16.5+/-2.1 days to 12.6+/-6.3 days (p value < 0.0001). The average time taken to reach the hospital, however, increased from 27+/-3 h to 36+/-4 h (p value < 0.0001). The rate of direct maternal deaths increased from 45.6% to 52.5% between 2019 and 2020(p-value-0.434).
Covid 19 pandemic has affected both maternal mortality and morbidity. Keeping the current situation in mind, it becomes increasingly important to develop patient education via electronic media and teleconsultations. One-stop portals and helplines which involve multidisciplinary teams should be available to all such pregnancies.
新冠疫情席卷全球。就孕产妇健康而言，它受到了直接和间接的影响。不仅女性受到新冠疾病的影响，医疗服务在可及性、可接近性和获取方面也受到了影响。本研究旨在分析由于新冠疫情，我院妇产科2019年至2020年期间孕产妇近死亡和孕产妇死亡趋势的变化，包括严重孕产妇结局（SMO）。
本回顾性研究在昌迪加尔医学教育与研究研究生院（PGIMER）的妇产科进行。分析了孕产妇死亡审查数据和孕产妇近死亡统计数据。这包括评估孕产妇死亡和产科近死亡的数量变化、各自的原因以及孕期特定于新冠的病死率。
总出生数从2019年的6056例降至2020年的4140例，而严重孕产妇结局的女性从2019年的4.6%增加到2020年的6.5%（p值<0.001）。近死亡发生率从2019年的3.5%显著增加到2020年的5.1%（p值<0.0001），孕产妇死亡率从每10万例出生1122例增加到每10万例出生1425例。出血是孕产妇近死亡的最常见原因，2019年为45.8%，2020年增至50.2%。2020年，近死亡的文盲患者百分比在统计学上有所降低（p值 - 0.004）。平均住院时间也从16.5±2.1天减少到12.6±6.3天（p值<0.0001）。然而，到达医院的平均时间从27±3小时增加到36±4小时（p值<0.0001）。2019年至2020年期间，直接孕产妇死亡率从45.6%增加到52.5%（p值 - 0.434）。
新冠疫情影响了孕产妇死亡率和发病率。考虑到当前形势，通过电子媒体和远程会诊开展患者教育变得越来越重要。所有此类孕妇都应可获得涉及多学科团队的一站式门户网站和热线服务。
