三级转诊中心宫内胎儿死亡患者的危险因素

K. Sinha, S. Pandey
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引用次数: 2

摘要

背景:在可用于衡量发展中国家卫生服务质量和影响的各种社区卫生指标中,围产期死亡率即使在今天也是最单一的指标之一。为了降低胎儿死亡率和在产妇保健部门制定计划,需要对死产的病因和相关风险因素进行记录和评估。目的:探讨患者宫内死胎的常见危险因素及其与宫内死胎的关系。方法:2018年1月至2019年9月在尼泊尔科哈尔布尔医学院妇产科进行以医院为基础的横断面研究。排除多胎妊娠、产时死亡和妊娠28周前诊断的胎儿死亡病例。排除后,对65例宫内死胎进行了研究。结果:IUFD患者绝大多数(78.4%)属于生育年龄(20-35岁),15.4% (p=0.008)属于<19岁,并伴有文盲(84.6%)。超过一半(58.5%)至少有一次ANC就诊,初产妇(17%)和早产儿(63.07%)。高血压疾病是最常见的产科并发症(36.92%),其次是原因不明(26.15%)、贫血(18.46%)、胎膜早破(15.4%)、APH(13.8%)。以低出生体重儿居多(63.69%),以男婴居多(63.1%)。结论:本研究发现的大多数危险因素是可以预防的。通过在产前保健和产时护理中对这些危险因素进行适当管理,可降低死产率。
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Risk Factors in Patients with Intrauterine Fetal Death at Tertiary Referral Centre
Background: Among various community health indicators available for measurement of quality and impact of health services in developing countries, perinatal mortality accounts one of the top most single indicators even today. Documentation and evaluation of the etiology and the associated risk factors for stillbirth is required in order to decrease the fetal mortality rate and to devise plan in maternal health sector. Objective: To find out common risk factors in patient and its association with intrauterine fetal death. Methods: A hospital based cross-sectional study carried out in the Department of OBSGYN, Nepalgunj Medical College, Kohalpur from Jan 2018 to September 2019.Cases of multiple pregnancies, intrapartum death and fetal death diagnosed before 28th weeks of gestation were excluded. After exclusion, 65 cases of intrauterine fetal death were studied. Results: Majority (78.4%) of the patients with IUFD belonged to the reproductive age group(20-35yrs) and (15.4%) belong to <19yrs (p=0.008) associated with illiteracy (84.6%). More than half (58.5%) had at least one ANC visit and were primigravida (17%) with preterm (63.07%). Hypertensive disorder was the commonest obstetric complication in these mothers (36.92%) followed by unexplained (26.15%), anaemia (18.46%), PROM (15.4%), APH (13.8%). Most of the babies were low birth weight (63.69%) and majority were males (63.1%). Conclusion: Majority of the risk factors found in the present study were preventable. Stillbirth rate can be reduced by proper management of these risk factors during antenatal care and intrapartum care.
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