...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>BMC Pregnancy and Childbirth >An audit of the initial resuscitation of severely ill patients presenting with septic incomplete miscarriages at a tertiary hospital in South Africa
【24h】

An audit of the initial resuscitation of severely ill patients presenting with septic incomplete miscarriages at a tertiary hospital in South Africa

机译：南非一家三级医院对患有败血性不完全流产的重症患者的初始复苏的审计

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Septic incomplete miscarriages remain a cause of maternal deaths in South Africa. There was an initial decline in mortality when a strict protocol based approach and the Choice of Termination of Pregnancy Act in South Africa were implemented in this country. However, a recent unpublished audit at the Pretoria Academic Complex (Kalafong and Steve Biko Academic Hospitals) suggested that maternal mortality due to this condition is increasing. The objective of this investigation is to do a retrospective audit with the purpose of identifying the reasons for the deteriorating mortality index attributed to septic incomplete miscarriage at Steve Biko Academic Hospital. A retrospective audit was performed on all patients who presented to Steve Biko Academic Hospital with a septic incomplete miscarriage from 1st January 2008 to 31st December 2010. Data regarding patient demographics, initial presentation, resuscitation and disease severity was collected from the “maternal near-miss”/SAMM database and the patient’s medical record. The shock index was calculated for each patient retrospectively. There were 38 SAMM and 9 maternal deaths during the study period. In the SAMM group 86.8% and in the maternal death group 77.8% had 2 intravenous lines for resuscitation. There was no significant improvement in the mean blood pressure following resuscitation in the SAMM group (p 0.67), nor in the maternal death group (p 0.883). The shock index before resuscitation was similar in the two groups but improved significantly following resuscitation in the SAMM group (p 0.002). Only 31.6% in the SAMM group and 11.1% in the maternal death group had a complete clinical examination, including a speculum examination of the cervix on admission. No antibiotics were administered to 21.1% in the SAMM group and to 33.3% in the maternal death group. The strict protocol management for patients with septic incomplete miscarriage was not adhered to. Physicians should be trained to recognise and react to the seriously ill patient. The use of the shock index in the identification and management of the critically ill pregnant patient needs to be investigated.
机译：化脓性不完全流产仍然是南非孕产妇死亡的原因。当在南非实施严格的基于协议的方法和南非的《终止妊娠选择法》时，死亡率开始出现下降。但是，比勒陀利亚学术中心（Kalafong和Steve Biko学术医院）最近未公开的审计表明，由于这种情况导致的孕产妇死亡率正在增加。这项调查的目的是进行回顾性审核，以查明史蒂夫·比科学术医院败血性不完全流产所致死亡率指数下降的原因。对从2008年1月1日至2010年12月31日就史蒂夫·比科学术医院就诊的所有败血性不完全流产患者进行了回顾性审核。关于患者人口统计学，初次就诊，复苏和疾病严重程度的数据来自“母亲未遂” / SAMM数据库和患者的病历。回顾性地计算每位患者的休克指数。在研究期间，有38例SAMM和9例产妇死亡。在SAMM组中86.8％，在孕产妇死亡组中77.8％进行了2次静脉复苏。复苏后，SAMM组的平均血压没有明显改善（p = 0.67），孕产妇死亡组也没有显着改善（p = 0.883）。两组复苏前的休克指数相似，但SAMM组复苏后的休克指数显着改善（P = 0.002）。 SAMM组仅31.6％，孕产妇死亡组11.1％接受了完整的临床检查，包括入院时对子宫颈进行窥镜检查。 SAMM组未给予抗生素的比例为21.1％，孕产妇死亡组未给予抗生素的比例为33.3％。未遵守对败血性不完全流产患者的严格协议管理。应培训医师识别重病患者并对之作出反应。需要研究休克指数在重症孕妇的识别和管理中的应用。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号