背景:孕产妇败血症是世界上孕产妇死亡的第三大原因。资源有限国家的妇女承担着与败血症有关的大部分负担。尽管与母体败血症相关的风险越来越大,在资源有限的国家,有有限的研究试图评估产妇败血症的影响.目前的研究确定了产妇败血症的结局和与不良产妇结局相关的因素。
方法:采用基于设施的回顾性横断面研究设计来评估临床表现,产妇结局,以及与母体败血症相关的因素。这项研究是在艾德综合专科医院进行的,提格雷,埃塞俄比亚,从2017年1月1日至2021年12月31日。社会人口统计学特征,使用描述性统计学方法分析了产妇败血症妇女的临床特征和结局.使用多变量逻辑回归确定因变量和自变量之间的关联。
结果:在27,350名活产儿中,298名母亲出现败血症,每10,000例活产中109例产妇败血症。有22名产妇死亡,病例死亡率为7.4%,产妇死亡率为每10万活产75例。23.5%和14.1%的研究参与者进入重症监护病房并使用机械呼吸机。分别。四分之一(24.2%)的母亲并发感染性休克。总的来说,24.2%的产妇败血症妇女有严重的产妇结局(SMO)。住院时间延长,具有两个及以上的奇偶校验,以肺部为感染的焦点,抗生素的转换,发生感染性休克与SMO显著相关。
结论:这项研究表明,在资源有限的环境中,孕产妇败血症继续导致显著的发病率和死亡率;相当数量的妇女经历死亡,重症监护室入院,和插管可归因于败血症。推荐的诊断方式和管理选择的不可用性导致了本研究中观察到的严重结果。为了避免怀孕期间感染的影响,在低收入国家,分娩和产后期间以及防止发展为败血症和败血症性休克,我们建议应采取协调一致的措施来建设医疗机构的诊断能力,有有效的感染预防和控制实践,并利用推荐的诊断和管理选项。
BACKGROUND: Maternal sepsis is the third leading cause of maternal death in the world. Women in resource-limited countries shoulder most of the burdens related to sepsis. Despite the growing risk associated with maternal sepsis, there are limited studies that have tried to assess the impact of maternal sepsis in resource-limited countries. The current study determined the outcomes of maternal sepsis and factors associated with having poor maternal outcomes.
METHODS: A facility-based retrospective cross-sectional study design was employed to assess the clinical presentation, maternal outcomes, and factors associated with maternal sepsis. The study was conducted in Ayder Comprehensive Specialized Hospital,
Tigray, Ethiopia, from January 1, 2017, to December 31, 2021. Sociodemographic characteristics, clinical characteristics and outcomes of women with maternal sepsis were analyzed using a descriptive statistic. The association between dependent and independent variables was determined using multivariate logistic regression.
RESULTS: Among 27,350 live births, 298 mothers developed sepsis, giving a rate of 109 maternal sepsis for every 10,000 live births. There were 22 maternal deaths, giving rise to a case fatality rate of 7.4% and a maternal mortality ratio of 75 per 100,000 live births. Admission to the intensive care unit and use of mechanical ventilator were observed in 23.5% and 14.1% of the study participants, respectively. A fourth (24.2%) of the mothers were complicated with septic shock. Overall, 24.2% of women with maternal sepsis had severe maternal outcomes (SMO). Prolonged hospital stay, having parity of two and above, having the lung as the focus of infection, switchof antibiotics, and developing septic shock were significantly associated with SMO.
CONCLUSIONS: This study revealed that maternal sepsis continues to cause significant morbidity and mortality in resource-limited settings; with a significant number of women experiencing death, intensive care unit admission, and intubation attributable to sepsis. The unavailability of recommended diagnostic modalities and management options has led to the grave outcomes observed in this study. To ward off the effects of infection during pregnancy, labor and postpartum period and to prevent progression to sepsis and septic shock in low-income countries, we recommend that concerted and meticulous efforts should be applied to build the diagnostic capacity of health facilities, to have effective infection prevention and control practice, and to avail recommended diagnostic and management options.