三级医院围产期死亡原因及可避免因素分析

Sunita Bhandari, Y. Dwa, Riya Sharma
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摘要

导言:围产期死亡是可以预防的,它反映了产前、分娩和对新生儿的护理质量。本研究的目的是评估2018-19年导致围产期死亡的原因和可避免因素,并将其与前两年在三级护理医院的情况进行比较。材料和方法:本研究对2018年7月至2019年7月期间所有死产和早期新生儿死亡进行回顾性分析。本年度对导致围产期死亡的围产期死亡率、原因和可避免因素进行了分析,并与KIST医学院和教学医院前两年的情况进行了比较。结果:2018-19年,PMR为16.09 / 1000。该医院此前在2017-18年和2016-17年进行的两项研究显示,围产期死亡率分别为14.61 /1000和16.27/1000。在2018-19年、2017-18年和2016-17年期间,围产期死亡最常见的主要原因分别是产时缺氧(30%)、早产(31.25%)和先天性异常(19%)。确定的最常见的可避免因素是,在过去三年中,产妇延迟寻求保健、产前检查不足以及服务提供者对危险迹象的产前咨询不足。结论:产妇延迟就医和对孕期危险体征缺乏了解是常见的可避免因素。应作出更多努力,提高产前保健访问期间孕妇对必要时早期寻求保健行为的认识。
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An Analysis of Causes and Avoidable Factors of Perinatal Deaths at Tertiary Care Hospital
Introduction: Perinatal deaths are potentially preventable and reflect the quality of care provided in the prenatal period, during labor, and to a newborn. The purpose of this study was to assess the causes and avoidable factors contributing to perinatal deaths in the year 2018-19 and compare these with the previous two years at Tertiary Care Hospital.Materials and Methods: This study was conducted from a retrospective analysis of all stillbirths and early neonatal deaths in the year July 2018 to July 2019. The Perinatal Mortality Rate, causes, and avoidable factors leading to perinatal deaths were analysed during this year and were compared with that of the previous two years at KIST Medical College and Teaching hospital.Results: PMR was 16.09 per 1000 births in the year 2018-19. Previous two studies at this hospital in the year 2017-18 and 2016-17 showed a Perinatal Mortality Rate of 14.61 and 16.27/1000 births respectively. The commonest primary cause of perinatal deaths was intrapartum hypoxia 6 (30%), preterm delivery 5 (31.25%), and congenital anomalies4 (19%) during the year 2018-19, 2017-18, and 2016-17 respectively. The most common avoidable factors identified were a maternal delay to seek health care, inadequate antenatal checkups, and inadequate antenatal counseling of danger signs by a service provider over the last three years.Conclusions: Maternal delay to seek health care and lack of maternal knowledge of danger signs during pregnancy were the common avoidable factors identified. More efforts should be made to raise awareness of pregnant women during antenatal care visits regarding early healthcare-seeking behavior when needed.
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