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首页> 外文期刊>Australian and New Zealand Journal of Obstetrics and Gynecology >Audit of severe acute maternal morbidity describing reasons for transfer and potential preventability of admissions to ICU.
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Audit of severe acute maternal morbidity describing reasons for transfer and potential preventability of admissions to ICU.

机译：对严重的急性孕产妇发病情况进行审核，描述了转移到ICU的原因和潜在的可预防性。

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BACKGROUND: Maternal mortality is a rare event in the developed world. Assessment of severe acute maternal morbidity (SAMM) is therefore an appropriate measure of the quality of maternity care. AIMS: The aim of the study was to conduct a retrospective audit of SAMM cases (pregnant women admitted to a New Zealand Intensive Care Unit) to describe clinical, socio-demographic characteristics, pregnancy outcomes and preventability. METHODS: Severe acute maternal morbidity cases were reviewed by a multidisciplinary panel to determine reasons for admission to ICU, to classify organ-system dysfunction and to determine whether the SAMM case was preventable or not. Inclusion criteria were: admission to ICU between 2005 and 2007 during pregnancy or within 42 days of delivery. RESULTS: Twenty-nine SAMM cases were reviewed, of which 10 (35%) were deemed preventable. The most common reasons for transfer to ICU were: the need for invasive vascular monitoring, hypotension and disseminated intravascular coagulation. The most frequent types of preventable events were: inadequate diagnosis/recognition of high-risk status, inappropriate treatment, communication problems and inadequate documentation. All five SAMM cases of septicaemia were deemed preventable. Of the ten preventable cases, three were Maori (50% of the Maori in total audit), four were Pacific (67% of the Pacific in total audit) and three were women of 'other' ethnicities (17.6%, 3 of 17 in the audit). CONCLUSIONS: An audit of SAMM cases describing reasons for transfer to ICU and preventability is feasible. We recommend that a prospective national SAMM audit process be introduced in New Zealand as a quality of care measure.
机译：背景：孕产妇死亡率在发达国家是罕见的事件。因此，评估严重的急性孕产妇发病率（SAMM）是衡量孕产妇护理质量的适当措施。目的：该研究的目的是对SAMM病例（新西兰重症监护病房收治的孕妇）进行回顾性审计，以描述其临床，社会人口统计学特征，妊娠结局和可预防性。方法：多学科专家小组审查了严重的急性孕产妇发病病例，以确定入ICU的原因，分类器官系统功能障碍以及确定SAMM病例是否可预防。纳入标准为：2005年至2007年之间在怀孕期间或分娩后42天内入ICU。结果：审查了29例SAMM病例，其中10例（35％）被认为是可以预防的。转移到ICU的最常见原因是：需要有创血管监测，低血压和弥散性血管内凝血。最常见的可预防事件类型是：高危状态的诊断/认识不足，不适当的治疗，沟通问题和文献不足。所有5例SAMM败血病病例都可以预防。在10例可预防的病例中，毛利人3例（占总审计量的50％），太平洋地区4例（占总审计量的67％），三人是“其他”族裔的妇女（17.6％，17例中有3例）审核）。结论：对描述转移到ICU的原因和可预防性的SAMM病例进行审计是可行的。我们建议在新西兰引入一个前瞻性的国家SAMM审核程序，作为一种护理质量措施。

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