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   Severe obstetric morbidity and its outcome in patients presenting in a tertiary care hospital of Karachi  
   
نویسنده Siddiqui Saima Aziz ,Soomro Nargis ,Shabih-ul-Hasnain Farah
منبع journal of the pakistan medical association - 2012 - دوره : 62 - شماره : 3 - صفحه:226 -231
چکیده    Objective: to determine the frequency, types (disease states) and outcome of severe obstetric morbidity in patients presenting at a public-sector tertiary care hospital. methods: the cross-sectional study was conducted at the obstetrics and gynaecology unit ii, civil hospital, karachi, from april to september 2010. consecutive cases of severe obstetric morbidity (near-miss), as defined by specific criteria, presenting in emergency were included. they were categorised into six groups: haemorrhage, hypertensive disorders in pregnancy, sepsis, ruptured uterus, anaemia, and a miscellaneous group encompassing morbidities not falling in the aforementioned groups. obstetric near-miss (onm) cases were described by disease-specific criteria. primary outcome measures were frequency of near-miss in each disease specific group, type (disease state) of near miss in a group, maternal outcome measures i.e. hospital stay>7 days, hysterectomy, urinary/faecal fistula, morbidity due to management intervention and maternal death. maternal near-miss ratio and mortality to near-miss ratio were calculated. secondary outcome measures were ventilator support for >24 hours, and intensive care admission for >48 hours. results: there were 1508 deliveries during the study period from which 130 patients met the inclusion criteria. among the 130 enrolled patients, obstetric near-miss (survivors) were 111. among the total of 1442 livebirths, the maternal near-miss ratio was calculated to be 76.97/1000 livebirths. nineteen maternal deaths resulted in the near-miss to mortality ratio of 5.8:1. haemorrhage (34.2%) was the most frequent group, followed by hypertensive disorders (29.1%) and ruptured uterus (11.53%). case fatality rates of sepsis (35%) and miscellaneous (30%) groups were the highest. hysterectomy rates were 3.60% and hospital stay > 7 days stood at 31.33%. the intensive care admission rate was 42.34%. conclusion: haemorrhage, hypertensive disorders and ruptured uterus were the leading causes of obstetric near-miss, whereas sepsis, acute fatty liver of pregnancy and peripartum cardiomyopathy resulted in the highest case fatalities.
کلیدواژه Postpartum haemorrhage ,Sepsis ,Uterine rupture ,Maternal mortality ,Hysterectomy
آدرس Dow University of Health Sciences, Civil Hospital, Department of Obstetrics & Gynaecology Unit II, Pakistan, Dow University of Health Sciences, Civil Hospital, Department Obstetrics & Gynaecology, Pakistan, Dow University of Health Sciences, Civil Hospital, Department of Obstetrics & Gynaecology Unit II, Pakistan
 
     
   
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