埃塞俄比亚迪拉大学转诊医院子痫前期妇女的产妇结局评估

Zerihun Figa, T. Temesgen, Etaferahu Belekle, Abas Ahimed, Ruth Tilahun
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引用次数: 0

摘要

背景:先兆子痫是妊娠20周后的高血压,以血压大于140/90 mm Hg为特征,使用Korotkoff V相声压测定舒张值,两次间隔4小时。它是一系列妊娠疾病中的一种,可导致包括产妇死亡在内的各种并发症。方法:采用回顾性横断面研究设计。本研究共招募295例样本,采用系统抽样技术选择2016年1月1日至2018年12月31日在迪拉大学转诊医院就诊的先兆子痫患者。使用预先测试的数据抽象工具进行病历审查。数据输入EpiData 4.4.2.1版本,导出到SPSS 25.0版本进行分析。使用二元和多元逻辑回归来确定变量之间的关联。估计校正优势比和95%置信区间来评估相关性的强度,用p值≤0.05来表示具有统计学显著性的水平。结果:本研究回顾了295例子痫前期妇女的病历。其中年龄在20-34岁之间的人数最多,为210人(72.2%)。重度子痫前期174例(58.0%)。重度子痫前期最常见的并发症为HELLP综合征81例(66.6%),其次为DIC 25例(20.5%),肾功能衰竭9例(7.4%),肝功能衰竭1例(0.8%)。产妇因子痫前期死亡6例,病死率为2%。多变量logistic回归结果显示,农村居民发生不良结局的风险是农村居民的5.038倍[AOR=5.038, 95%CI 1.971 ~ 12.879],胎龄≤33周发生不良结局的风险是农村居民的3.67倍[AOR=3.67, 95%CI 1.829 ~ 7.364],诊断为重度先兆子痫的住院妇女发生不良结局的风险是农村居民的6.42倍[AOR=6.42, 95%CI 2.017 ~ 21.103]。结论和建议:虽然目前有改善产妇健康的设想,但这项研究表明,产妇并发症在子痫前期妇女中很常见。子痫前期最常见的产妇并发症是HELLP综合征、DIC和肾衰竭。特别是在初级保健中心工作的卫生保健专业人员应该接受适当的培训,以便对前来ANC的妇女进行即时管理和咨询,并及时转诊有严重症状的先兆子痫妇女。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of Maternal Outcome Among Preeclamptic Women at Dilla University Referral Hospital, Dilla Ethiopia
: Background: Pre-eclampsia is hypertension in pregnancy after 20weeks of gestation characterized blood pressure greater than 140/90 mm Hg, using the Korotkoff phase V sound for the diastolic value, on two occasions 4 hours apart. It is one of a spectrum of pregnancy disorders which result in different complications including maternal death. Methodology: Retrospective cross-sectional study design was employed. A total of 295 samples were recruited and systematic sampling technique was used to select study subjects who were admitted with preeclampsia from January1, 2016 and December 31, 2018 at Dilla University Referral Hospital. Medical records review was done using pretested data abstraction tool. Data was entered in EpiData version 4.4.2.1and exported into SPSS (statistical package of social science) version 25.0 for analysis. Binary and multiple logistic regressions were used to identify association between variables. Adjusted odds ratio along with 95% confidence interval was estimated to assess the strength of the association, and a p-value ≤ 0.05 was used to declare the level of statistical significance. Results: In this study 295 medical charts of pre-eclamptic women were reviewed. The most 210 (72.2%) of the participants were between the age of 20-34years. Severe type of preeclampsia was 174 (58.0%). HELLP syndrome was the most common complication of severe preeclampsia 81 (66.6%) followed by DIC, renal failure and liver failure, 25 (20.5%), 9 (7.4%) and 1 (0.8%) respectively. Maternal deaths due to preeclampsia were 6 this gives case fatality of 2%. In multivariable logistic regression, rural residence has 5.038 times more risk of unfavorable maternal outcome [AOR=5.038, 95%CI 1.971-12.879], gestational age ≤33 weeks has 3.67 times higher risk of unfavorable maternal outcome [AOR=3.67, 95%CI 1.829-7.364] and admission of women with diagnosis of sever preeclampsia has 6.42 times higher risk of unfavorable maternal outcome [AOR=6.42, 95%CI 2.017-21.103]. Conclusion and recommendation: Although there was current envisaged on maternal health improvement, this study has shown that maternal complications were common among pre-eclamptic women. The most common maternal complications due to preeclampsia were HELLP syndrome, DIC and renal failure. Health care professionals specially who work at PHC center should take appropriate trainings on immediate management and counseling a women coming for ANC and prompt referral for preeclampsia women with severity sign.
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