The WOMAN Trial: Clinical and Contextual Factors Surrounding the Deaths of 483 Women Following Post-Partum Hemorrhage in Developing Countries
| Autor: | Picetti, R, Miller, L, Shakur-Still, H, Pepple, T, Beaumont, D, Balogun, E, Asonganyi, E, Chaudhri, R, El-Sheikh, M, Vwalika, B, Arulkumaran, S, Roberts, I, WOMAN trial collaborators |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Asia Time Factors Blood transfusion medicine.medical_treatment lcsh:Gynecology and obstetrics Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy Cause of Death Case fatality rate medicine Humans Blood Transfusion Caesarean section 030212 general & internal medicine Developing Countries lcsh:RG1-991 Cause of death 030219 obstetrics & reproductive medicine Cesarean Section business.industry Obstetrics Mortality rate Postpartum Hemorrhage Postpartum Period Pregnancy Outcome Obstetrics and Gynecology Anemia General Medicine medicine.disease Antifibrinolytic Agents 3. Good health Europe Maternal Mortality Tranexamic Acid Africa Female Maternal death business Postpartum period Research Article |
| Zdroj: | BMC Pregnancy and Childbirth, Vol 20, Iss 1, Pp 1-9 (2020) BMC Pregnancy and Childbirth |
| ISSN: | 1533-9866 0029-7828 1471-2393 |
| DOI: | 10.1097/01.ogx.0000723728.09046.e3 |
| Popis: | The etiology of maternal mortality is postpartum hemorrhage in approximately 8.0% of cases in developed countries and 19.7% in developing countries. As a leading cause of maternal death, its prevention and early treatment are a priority. As part of the WOMANTrial, a randomized trial of tranexamic acid to treat postpartum hemorrhage, information on the causes ofmaternal death was recorded. The aim of this study was to review the circumstances of maternal death inmore than 20,000 women in 21 countries. The WOMAN Trial demonstrated that tranexamic acid reduced maternal death in women with postpartum hemorrhage. The study took place between 2010 and 2016 in 193 hospitals in 21 countries and recruited 20,060 women who were 16 years or older and were diagnosed with postpartumhemorrhage following vaginal or cesarean deliveries. In cases ofmaternal death, obstetricians were asked to record the cause of death and provide a brief narrative of the circumstances surrounding the death. Of the 20,060 women recruited for the trial, 12,343 were from Africa, 6030 from Asia, and 1049 from Europe. A total of 483 deathswere recorded, with case fatality rates of 3.0%(n = 375) in Africa and 1.7%(n = 105) in Asia; there were no deaths in the European cohort. Narratives were obtained for 52% of the recorded deaths. The odds of maternal death were 5 times higher in cases involving stillbirths versus live births (odds ratio = 5.26, 95%confidence interval = 4.34 6.39). The risk of death was also associated with more than 1000 mL of blood loss, a systolic blood pressure of |
| Databáze: | OpenAIRE |
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