Major post-partum hemorrhage rate in a I level hospital: data analysis of substandard care and near-miss cases.

Autor:	Zanini A; Obstetrics and Gynecology Unit, Sacra Famiglia - Fatebenefratelli Hospital, Erba, Como, Italy., Inzoli A; Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy - a.inzoli2@campus.unimib.it., Andreotti C; Obstetrics and Gynecology Unit, Sacra Famiglia - Fatebenefratelli Hospital, Erba, Como, Italy., Miglietta M; Sacra Famiglia - Fatebenefratelli Hospital, Erba, Como, Italy., Mingozzi S; Alice Springs Hospital, Alice Springs, Australia., Armitano F; Obstetrics and Gynecology Unit, Sacra Famiglia - Fatebenefratelli Hospital, Erba, Como, Italy., Rezzonico E; Obstetrics and Gynecology Unit, Sacra Famiglia - Fatebenefratelli Hospital, Erba, Como, Italy.
Jazyk:	angličtina
Zdroj:	Minerva obstetrics and gynecology [Minerva Obstet Gynecol] 2023 Jun; Vol. 75 (3), pp. 213-218. Date of Electronic Publication: 2022 Feb 11.
DOI:	10.23736/S2724-606X.22.04987-9
Abstrakt:	Background: Post-partum hemorrhage continues to be a leading cause of maternal mortality and morbidity. The aim of this study was to estimate the prevalence of major hemorrhage, near-miss cases and substandard care in a I level hospital. Methods: We conducted a retrospective cohort study of pregnant women between 2003 and 2018 who had a blood loss ≥1500 mL or who required one or more blood transfusions. We assessed near-miss cases and substandard care. Results: Over the 16 years, there were 14,523 births: 156 women (1.07%) had a blood loss ≥1500 mL or required one or more blood transfusions. There were 16 near-miss cases and no maternal deaths. Twenty-three cases required transfer to the Intensive Care Unit (11.5%), in 3.5% of non near-miss cases and in 81.2% of near-miss cases (P<0.001). We identified substandard care in 36.4% of low risk women, and in 62.5% of near-miss cases (P=0.04). Conclusions: After dividing the cases in a first period (2003-2010) and a second period (2011-2018), we highlighted 11.6% near-miss cases in the first period and 8.8% in the second period (P=NS). The procedures adopted following the failure of the pharmacological therapy changed over the two periods: uterine packs with sterile gauzes went from 17.9% in the 2003-2010 timeframe, to 2.4% in the 2011-2018 (P=0.01). While the use of uterine balloon went from 12.8% (2003-2010) to 64.3% (2011-2018) (P<0.001).
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu