PDF(Pubmed)
Abstract：
UNASSIGNED: In Brazil, postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. Data on the profile of women and risk factors associated with PPH are sparse. This study aimed to describe the profile and management of patients with PPH, and the association of risk factors for PPH with severe maternal outcomes (SMO).
UNASSIGNED: A cross-sectional study was conducted in Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) obstetric intensive care unit (ICU) between January 2012 and March 2020, including patients who gave birth at the hospital and that were admitted with PPH to the ICU.
UNASSIGNED: The study included 358 patients, of whom 245 (68.4%) delivered in the IMIP maternity, and 113 (31.6%) in other maternity. The mean age of the patients was 26.7 years, with up to eight years of education (46.1%) and a mean of six prenatal care. Uterine atony (72.9%) was the most common cause, 1.6% estimated blood loss, 2% calculated shock index (SI), 63.9% of patients received hemotransfusion, and 27% underwent hysterectomy. 136 cases of SMO were identified, 35.5% were classified as maternal near miss and 3.0% maternal deaths. Multiparity was associated with SMO as an antepartum risk factor (RR=1.83, 95% CI1.42-2.36). Regarding intrapartum risk factors, abruptio placentae abruption was associated with SMO (RR=2.2 95% CI1.75-2.81). Among those who had hypertension (49.6%) there was a lower risk of developing SMO.
UNASSIGNED: The principal factors associated with poor maternal outcome were being multiparous and placental abruption.
UNASSIGNED: A cross-sectional study was conducted in Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) obstetric intensive care unit (ICU) between January 2012 and March 2020, including patients who gave birth at the hospital and that were admitted with PPH to the ICU.
UNASSIGNED: The study included 358 patients, of whom 245 (68.4%) delivered in the IMIP maternity, and 113 (31.6%) in other maternity. The mean age of the patients was 26.7 years, with up to eight years of education (46.1%) and a mean of six prenatal care. Uterine atony (72.9%) was the most common cause, 1.6% estimated blood loss, 2% calculated shock index (SI), 63.9% of patients received hemotransfusion, and 27% underwent hysterectomy. 136 cases of SMO were identified, 35.5% were classified as maternal near miss and 3.0% maternal deaths. Multiparity was associated with SMO as an antepartum risk factor (RR=1.83, 95% CI1.42-2.36). Regarding intrapartum risk factors, abruptio placentae abruption was associated with SMO (RR=2.2 95% CI1.75-2.81). Among those who had hypertension (49.6%) there was a lower risk of developing SMO.
UNASSIGNED: The principal factors associated with poor maternal outcome were being multiparous and placental abruption.
摘要：
■在巴西，产后出血（PPH）是孕产妇发病和死亡的主要原因。关于女性和与PPH相关的危险因素的数据很少。本研究旨在描述PPH患者的概况和管理，以及PPH的危险因素与严重产妇结局（SMO）的关系。
■一项横断面研究是在医学研究所整合教授中进行的。FernandoFigueira（IMIP）产科重症监护病房（ICU）2012年1月至2020年3月，包括在医院分娩并因PPH入院ICU的患者。
■该研究包括358名患者，其中245人(68.4%)在IMIP产妇中分娩，其他产妇113例（31.6%）。患者的平均年龄为26.7岁,接受长达8年的教育（46.1％）和平均6次产前护理。子宫收缩乏力（72.9%）是最常见的原因，1.6%估计失血,2%计算的冲击指数(SI)，63.9%的患者接受了输血,27%接受了子宫切除术。发现136例SMO，35.5%的产妇被归类为接近错过，3.0%的产妇死亡。多胎与SMO作为产前危险因素相关（RR=1.83，95％CI1.42-2.36）。关于产期风险因素，胎盘早剥与SMO相关(RR=2.295%CI1.75-2.81)。在患有高血压的人（49.6％）中，发展SMO的风险较低。
■与不良产妇结局相关的主要因素是经胎和胎盘早剥。
■一项横断面研究是在医学研究所整合教授中进行的。FernandoFigueira（IMIP）产科重症监护病房（ICU）2012年1月至2020年3月，包括在医院分娩并因PPH入院ICU的患者。
■该研究包括358名患者，其中245人(68.4%)在IMIP产妇中分娩，其他产妇113例（31.6%）。患者的平均年龄为26.7岁,接受长达8年的教育（46.1％）和平均6次产前护理。子宫收缩乏力（72.9%）是最常见的原因，1.6%估计失血,2%计算的冲击指数(SI)，63.9%的患者接受了输血,27%接受了子宫切除术。发现136例SMO，35.5%的产妇被归类为接近错过，3.0%的产妇死亡。多胎与SMO作为产前危险因素相关（RR=1.83，95％CI1.42-2.36）。关于产期风险因素，胎盘早剥与SMO相关(RR=2.295%CI1.75-2.81)。在患有高血压的人（49.6％）中，发展SMO的风险较低。
■与不良产妇结局相关的主要因素是经胎和胎盘早剥。
