Early Postpartum Complications and Maternal Mortality: An Experience of Mymensingh Medical College Hospital, Bangladesh

Community Based Medical Journal Pub Date : 2022-03-20 DOI:10.3329/cbmj.v10i2.59149

Sadia Nusrat Alamgir, Kawsar Nigar, K. Nahar

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Abstract

A cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital (MMCH), Bangladesh, between April and September of 2010, to observe and evaluate common complications in early puerperium. A total of 384 patients were selected for the study, who were admitted with immediate postpartum complications, or who experienced complications after delivery at MMCH. Most of the patients 202(52.6%) belongs to 21-30 years age group followed by 118(30.73%) in >30 years and 64(16.67%) in ≤20 years group. Low parity accounts for most patients, 217(56.5%), while grand multiparity was documented in 42(10.9%) patients. 211(54.95%) patients had no history of antenatal checkup. 179(46.62%) patients had home delivery, while the rest had institutional delivery. 239(62.24%) patients had normal vaginal delivery, while 129(33.6%) had Caesarean operation, 7(1.82%) needed vacuum extraction and 2.34% had forceps’ delivery. 146(38.02%) had their delivery without attending doctor, nurse/midwife or skilled birth attendant. Most of the patients, 281(73.18%), had their symptoms and signs within 24 hours of delivery, while 41(10.67%) and 62(16.15%) had within 48 hours and within 7 days respectively. Primary postpartum haemorrhage (PPH) was the leading complication found in 114(29.68%) patients, while the other major complications were puerperal sepsis 53(13.8%), urinary tract infection 40(10.42%), postpartum eclampsia 38(9.9%). 329(85.68%) patients were discharged without any morbidity; however, maternal mortality was observed in 18(4.68%) cases. Puerperal sepsis 5(28%), postpartum eclampsia 4(22%) and pulmonary embolism 3(17%) were the leading causes of mortality. Skilled obstetric care, active management of third stage of labour, prevention and treatment of anaemia, and maintenance of strict asepsis during delivery can prevent a considerable incidence of those complications. CBMJ 2021 January: vol. 10 no. 02 P: 85-90

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产后早期并发症和产妇死亡率:孟加拉国迈门辛格医学院医院的经验

2010年4月至9月，在孟加拉国迈门辛格医学院医院妇产科进行了一项横断面研究，以观察和评估产褥期早期常见并发症。共有384名患者被选为研究对象，这些患者有产后立即并发症，或在MMCH分娩后出现并发症。患者202例(52.6%)属于21 ~ 30岁年龄组，>30岁组118例(30.73%)，≤20岁组64例(16.67%)。低胎次占大多数，217例(56.5%)，而多胎次有42例(10.9%)。211例(54.95%)患者无产前检查史。179例(46.62%)患者在家中分娩，其余患者在医院分娩。阴道正常分娩239例(62.24%)，剖宫产129例(33.6%)，吸尘7例(1.82%)，产钳分娩2.34%。146例(38.02%)在没有主治医生、护士/助产士或熟练助产士的情况下分娩。281例(73.18%)患者在分娩24小时内出现症状和体征，48小时内出现41例(10.67%)，7天内出现62例(16.15%)。114例(29.68%)患者的主要并发症为产后原发性出血(PPH)，其他主要并发症为产后败血症53例(13.8%)、尿路感染40例(10.42%)、产后子痫38例(9.9%)。出院病例329例(85.68%)，无发病;然而，产妇死亡率为18例(4.68%)。产后败血症(28%)、产后子痫(22%)和肺栓塞(17%)是导致死亡的主要原因。熟练的产科护理、对分娩第三阶段的积极管理、预防和治疗贫血以及在分娩期间保持严格的无菌，可以防止这些并发症的大量发生。中华医学杂志2021年1月第10卷第10期[02:85 . 90

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Community Based Medical Journal

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