Raíssa Isabelle Leão Martins, Jussara de Souza Mayrink Novais, Zilma Silveira Nogueira Reis
{"title":"电子健康记录中的产后出血:入院时的风险因素和院内发生率。","authors":"Raíssa Isabelle Leão Martins, Jussara de Souza Mayrink Novais, Zilma Silveira Nogueira Reis","doi":"10.61622/rbgo/2024AO14","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Postpartum hemorrhage (PPH) is the leading cause of maternal death globally. Therefore, prevention strategies have been created. The study aimed to evaluate the occurrence of PPH and its risk factors after implementing a risk stratification at admission in a teaching hospital.</p><p><strong>Methods: </strong>A retrospective cohort involving a database of SISMATER® electronic medical record. Classification in low, medium, or high risk for PPH was performed through data filled out by the obstetrician-assistant. PPH frequency was calculated, compared among these groups and associated with the risk factors.</p><p><strong>Results: </strong>The prevalence of PPH was 6.8%, 131 among 1,936 women. Sixty-eight (51.9%) of them occurred in the high-risk group, 30 (22.9%) in the medium-risk and 33 (25.2%) in the low-risk group. The adjusted-odds ratio (OR) for PPH were analyzed using a confidence interval (95% CI) and was significantly higher in who presented multiple pregnancy (OR 2.88, 95% CI 1.28 to 6.49), active bleeding on admission (OR 6.12, 95% CI 1.20 to 4.65), non-cephalic presentation (OR 2.36, 95% CI 1.20 to 4.65), retained placenta (OR 9.39, 95% CI 2.90 to 30.46) and placental abruption (OR 6.95, 95% CI 2.06 to 23.48). Vaginal delivery figured out as a protective factor (OR 0.58, 95% CI 0.34 to 0.98).</p><p><strong>Conclusion: </strong>Prediction of PPH is still a challenge since its unpredictable factor arrangements. The fact that the analysis did not demonstrate a relationship between risk category and frequency of PPH could be attributable to the efficacy of the strategy: Women classified as \"high-risk\" received adequate medical care, consequently.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075434/pdf/","citationCount":"0","resultStr":"{\"title\":\"Postpartum hemorrhage in electronic health records: risk factors at admission and in-hospital occurrence.\",\"authors\":\"Raíssa Isabelle Leão Martins, Jussara de Souza Mayrink Novais, Zilma Silveira Nogueira Reis\",\"doi\":\"10.61622/rbgo/2024AO14\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Postpartum hemorrhage (PPH) is the leading cause of maternal death globally. Therefore, prevention strategies have been created. The study aimed to evaluate the occurrence of PPH and its risk factors after implementing a risk stratification at admission in a teaching hospital.</p><p><strong>Methods: </strong>A retrospective cohort involving a database of SISMATER® electronic medical record. Classification in low, medium, or high risk for PPH was performed through data filled out by the obstetrician-assistant. PPH frequency was calculated, compared among these groups and associated with the risk factors.</p><p><strong>Results: </strong>The prevalence of PPH was 6.8%, 131 among 1,936 women. Sixty-eight (51.9%) of them occurred in the high-risk group, 30 (22.9%) in the medium-risk and 33 (25.2%) in the low-risk group. The adjusted-odds ratio (OR) for PPH were analyzed using a confidence interval (95% CI) and was significantly higher in who presented multiple pregnancy (OR 2.88, 95% CI 1.28 to 6.49), active bleeding on admission (OR 6.12, 95% CI 1.20 to 4.65), non-cephalic presentation (OR 2.36, 95% CI 1.20 to 4.65), retained placenta (OR 9.39, 95% CI 2.90 to 30.46) and placental abruption (OR 6.95, 95% CI 2.06 to 23.48). Vaginal delivery figured out as a protective factor (OR 0.58, 95% CI 0.34 to 0.98).</p><p><strong>Conclusion: </strong>Prediction of PPH is still a challenge since its unpredictable factor arrangements. The fact that the analysis did not demonstrate a relationship between risk category and frequency of PPH could be attributable to the efficacy of the strategy: Women classified as \\\"high-risk\\\" received adequate medical care, consequently.</p>\",\"PeriodicalId\":74699,\"journal\":{\"name\":\"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-03-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075434/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.61622/rbgo/2024AO14\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.61622/rbgo/2024AO14","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的:产后出血(PPH)是全球产妇死亡的主要原因。因此,预防策略应运而生。本研究旨在评估一家教学医院在实施入院风险分层后的 PPH 发生率及其风险因素:方法:通过 SISMATER® 电子病历数据库进行回顾性队列分析。通过产科助理填写的数据对 PPH 进行低、中、高风险分层。计算了PPH发生率,比较了这些组别之间的差异,并将其与风险因素联系起来:在 1 936 名产妇中,PPH 的发生率为 6.8%,共 131 人。其中 68 例(51.9%)发生在高危组,30 例(22.9%)发生在中危组,33 例(25.2%)发生在低危组。使用置信区间(95% CI)分析了 PPH 的调整比例(OR),结果显示,多胎妊娠(OR 2.88,95% CI 1.28 至 6.49)、入院时活动性出血(OR 6.12,95% CI 1.20 至 4.65)、非头位(OR 2.36,95% CI 1.20 至 4.65)、胎盘滞留(OR 9.39,95% CI 2.90 至 30.46)和胎盘早剥(OR 6.95,95% CI 2.06 至 23.48)。阴道分娩是一个保护因素(OR 0.58,95% CI 0.34 至 0.98):结论:PPH 的预测仍是一项挑战,因为其因素安排难以预测。分析并未显示风险类别与 PPH 发生频率之间的关系,这可能是由于该策略的有效性:因此,被列为 "高风险 "的妇女得到了适当的医疗护理。
Postpartum hemorrhage in electronic health records: risk factors at admission and in-hospital occurrence.
Objective: Postpartum hemorrhage (PPH) is the leading cause of maternal death globally. Therefore, prevention strategies have been created. The study aimed to evaluate the occurrence of PPH and its risk factors after implementing a risk stratification at admission in a teaching hospital.
Methods: A retrospective cohort involving a database of SISMATER® electronic medical record. Classification in low, medium, or high risk for PPH was performed through data filled out by the obstetrician-assistant. PPH frequency was calculated, compared among these groups and associated with the risk factors.
Results: The prevalence of PPH was 6.8%, 131 among 1,936 women. Sixty-eight (51.9%) of them occurred in the high-risk group, 30 (22.9%) in the medium-risk and 33 (25.2%) in the low-risk group. The adjusted-odds ratio (OR) for PPH were analyzed using a confidence interval (95% CI) and was significantly higher in who presented multiple pregnancy (OR 2.88, 95% CI 1.28 to 6.49), active bleeding on admission (OR 6.12, 95% CI 1.20 to 4.65), non-cephalic presentation (OR 2.36, 95% CI 1.20 to 4.65), retained placenta (OR 9.39, 95% CI 2.90 to 30.46) and placental abruption (OR 6.95, 95% CI 2.06 to 23.48). Vaginal delivery figured out as a protective factor (OR 0.58, 95% CI 0.34 to 0.98).
Conclusion: Prediction of PPH is still a challenge since its unpredictable factor arrangements. The fact that the analysis did not demonstrate a relationship between risk category and frequency of PPH could be attributable to the efficacy of the strategy: Women classified as "high-risk" received adequate medical care, consequently.