A case series study of perinatal deaths at one referral center in rural post-conflict Liberia.
A case series study of perinatal deaths at one referral center in rural post-conflict Liberia.
复制标题
对冲突后利比里亚农村一个转诊中心围产期死亡的病例系列研究。
DOI：
10.1007/s10995-013-1232-y
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发表时间：
2014
影响因子：
2.3
通讯作者：
Boyd,CarolJ
中科院分区：
文献类型：
--
作者：
Lori,JodyR;Rominski,Sarah;Osher,BarbaraF;Boyd,CarolJ
本研究的总体目标是进一步了解导致利比里亚一家繁忙的农村转诊医院围产期死亡率高的因素。具体目的是：(1)分析经历过围产期损失的妇女的医疗和非医疗因素的记录；(2)描述所有记录的死产和新生儿早期死亡的时间和原因；(3)了解在这种情况下死产和新生儿早期死亡的相关因素。这项病例系列研究是通过对2010日历年期间利比里亚中北部最大的农村转诊医院发生的所有围产期死亡进行回顾性医院记录审查进行的。对1 656例分娩的记录审查确定了196例围产期死亡；143例为死产，53例为新生儿早期死亡。大多数死产（56.6%）表现为产前死产，入院时没有记录胎心音。当死产发生时，31%的病例没有在图表中记录产妇或产科诊断。在53例早期新生儿死亡中，47.2%发生在婴儿出生的第一天，最常见的诊断是出生窒息/ Apgar评分差。清晰和简明的文件是了解低资源国家高围产期死亡率的关键。需要标准化的详细文件，以便为临床实践的变化提供信息，并制定可行的解决方案，以减少全世界围产期死亡人数。
The overall objective of this study was to further our understanding of the factors contributing to the high perinatal mortality rates at a busy rural, referral hospital in Liberia. The specific aims were to: (1) analyze the records of women who experienced a perinatal loss for both medical and nonmedical contributing factors; (2) describe the timing and causes of all documented stillbirths and early neonatal deaths; and (3) understand the factors surrounding stillbirth and early neonatal death in this context. This case series study was conducted through a retrospective hospital-based record review of all perinatal deaths occurring at the largest rural referral hospital in north-central Liberia during the 2010 calendar year. A record review of 1,656 deliveries identified 196 perinatal deaths; 143 classified as stillbirth and 53 were classified as early neonatal death. The majority of stillbirths (56.6 %) presented as antenatal stillbirths with no fetal heart tones documented upon admission. Thirty-one percent of cases had no maternal or obstetrical diagnosis recorded in the chart when a stillbirth occurred. Of the 53 early neonatal deaths, 47.2 % occurred on day one of the infant’s life with birth asphyxia/poor Apgar scores being the diagnosis listed most frequently. Clear and concise documentation is key to understanding the high perinatal death rates in low resource countries. Standardized, detailed documentation is needed to inform changes to clinical practice and develop feasible solutions to reduce the number of perinatal deaths worldwide.