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采用世界卫生组织“孕产妇接近死亡”标准对子痫女性患者的孕产妇接近死亡和死亡情况分析

Maternal Near Miss and Death Among Women with Eclampsia Using WHO Near Miss Criteria.

作者信息

Ghosh Debnath, Chaudhuri Snehamay, Sahu Bheshna, Chakraborty Anwesha

机构信息

Department of Obstetrics and Gynecology, Midnapore Medical College, Paschim Midnapore, Midnapore, West Bengal India.

Burdwan, India.

出版信息

J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):235-241. doi: 10.1007/s13224-023-01931-z. Epub 2024 Feb 1.

Abstract

OBJECTIVE

The aim of the study was to estimate the prevalence of maternal near miss (MNM) and maternal death and to identify the factors associated with severe maternal outcome in women with eclampsia according to the World Health Organization (WHO) maternal near-miss criteria.

METHOD

A cross-sectional study was carried out over a period of 12 months incorporating pregnant women diagnosed as eclampsia during antepartum and postpartum period. The definition of maternal near miss was applied according to the WHO near-miss criteria. Data were collected in a case record form specially designed for the study and analyzed using statistical software.

RESULT

A total of 229 women with eclampsia included in the study over a period of 1 year. Among 229 women with eclampsia, 75 (32.75%) women diagnosed as maternal near miss (MNM), and 6 (2.62%) women had maternal death. Causes of near miss were neurological dysfunction (30.66%), respiratory dysfunction (24%), hematological dysfunction (18.67%), cardiological dysfunction (16%), hepatic dysfunction (10.67%) and uterine dysfunction (5.33%). Maternal near-miss ratio is 4.91 per 1000 live births, and severe maternal outcome ratio is 5.30 per 1000 live birth. Maternal near-miss mortality ratio (MNM:1MD) is 12.5:1, and mortality index is 7.40.

CONCLUSION

The study shows that there is scope to improve antenatal care and utilization of health facilities. Early diagnosis, good perinatal supervision and appropriate treatment can ameliorate many cases.

摘要

目的

本研究旨在根据世界卫生组织(WHO)的孕产妇险些死亡标准,估算孕产妇险些死亡(MNM)和孕产妇死亡的发生率,并确定子痫妇女严重孕产妇结局的相关因素。

方法

开展了一项为期12个月的横断面研究,纳入产前和产后被诊断为子痫的孕妇。根据WHO的险些死亡标准应用孕产妇险些死亡的定义。数据通过专门为该研究设计的病例记录表收集,并使用统计软件进行分析。

结果

在1年的时间里,共有229名子痫妇女纳入研究。在229名子痫妇女中,75名(32.75%)妇女被诊断为孕产妇险些死亡(MNM),6名(2.62%)妇女发生孕产妇死亡。险些死亡的原因包括神经功能障碍(30.66%)、呼吸功能障碍(24%)、血液功能障碍(18.67%)、心脏功能障碍(16%)、肝功能障碍(10.67%)和子宫功能障碍(5.33%)。孕产妇险些死亡率为每1000例活产4.91例,严重孕产妇结局率为每1000例活产5.30例。孕产妇险些死亡与孕产妇死亡比(MNM:1MD)为12.5:1,死亡率指数为7.40。

结论

该研究表明,改善产前护理和卫生设施的利用仍有空间。早期诊断、良好的围产期监护和适当的治疗可以改善许多病例。

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本文引用的文献

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J Obstet Gynaecol India. 2021 Aug;71(4):369-378. doi: 10.1007/s13224-021-01432-x. Epub 2021 Mar 4.
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J Obstet Gynaecol India. 2016 Oct;66(Suppl 1):172-6. doi: 10.1007/s13224-015-0807-5. Epub 2016 Jan 8.
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Maternal and fetal outcome in women with hypertensive disorders of pregnancy: the impact of prenatal care.
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