Trends in postpartum haemorrhage
Trends in postpartum haemorrhage
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DOI：
10.1111/j.1467-842x.2006.tb00109.x
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发表时间：
2006-04-01
影响因子：
3.5
通讯作者：
Fischer, WE
中科院分区：
文献类型：
--
作者：
Cameron, CA;Roberts, CL;Fischer, WE
目的：为了评估产后出血（PPH）在新南威尔士州（NSW）的趋势和结果。方法：一项以人口为基础的描述性研究的所有52,151名妇女谁有一个PPH无论是在住院期间为他们的婴儿出生或需要重新入院到医院之间的1994年和2002年。数据来自新南威尔士州医院住院患者的去识别计算机化人口普查，并进行分析，以检查随时间推移的趋势。结局指标包括产妇死亡、子宫切除术、入住重症监护室（ICU）、输血和主要产妇发病率，包括减少子宫供血的程序、急性肾功能衰竭和产后凝血缺陷。1994年至2002年的数量和调整入院时PPH的发生率从8.3%上升到10.7%。经产妇年龄和分娩方式调整的PPH发生率与未调整的发生率相似。输血率增加了6倍，从出血妇女的1.9%增加到11.7%。PPH的再入院率从分娩的1.2%下降到0.9%。这些变化具有统计学意义。子宫切除术、减少子宫血液供应的手术、入住ICU、急性肾衰竭或凝血功能缺陷的发生率没有显着变化。结论：入院期间PPH发生率的增加令人担忧。PPH的增加不能用母亲年龄的增加或剖腹产来解释。关联的出生和出院数据可以确定PPH的增加是否由产科实践或人口的其他变化引起。
Objective: To assess trends and outcomes of postpartum haemorrhage (PPH) in New South Wales (NSW).Methods: A population-based descriptive study of all 52,151 women who had a PPH either during the hospital stay for the birth of their baby or requiring a re-admission to hospital between 1994 and 2002. Data were obtained from the de-identified computerised census of NSW hospital in-patients and analysed to examine trends overtime. The outcome measures included maternal death, hysterectomy, admission to intensive care unit (ICU), transfusion and major maternal morbidity, including procedures to reduce blood supply to the uterus, acute renal failure and postpartum coagulation defects.Results: From 1994 to 2002 both the number and adjusted (for under-reporting) rate of PPH during the birth admission increased from 8.3% of deliveries to 10.7%. The rate of PPH adjusted for maternal age and mode of delivery was similar to the unadjusted rate. There was a sixfold increase in the rate of transfusions from 1.9% of women who haemorrhaged to 11.7%. Hospital readmissions for PPH declined from 1.2% of deliveries to 0.9%. These were statistically significant changes. There were no significant changes in the rate of hysterectomies, procedures to reduce blood supply to the uterus, admissions to ICU, acute renal failure or coagulation defects.Conclusion: The increased rate of PPH during the birth admission is concerning. The increase in PPH could not be explained by increasing maternal age or caesarean sections. Linked birth and hospital discharge data could determine whether the increase in PPH is caused by other changes in obstetric practices or population.