量化失血值显示出高率未被诊断的产后出血
Burhan A Khan1,2,3, Alexandria Weston1, Aubrey Jaeger3
1Department of Family & Community Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA.
概括
量化血液损失测量显示,在美国,产后出血 (PPH) 的诊断不足显著. 这项研究突出了不同种族之间PPH率的差异.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 产后出血 (PPH) 是导致母亲发病和死亡的主要原因.
- 目前的PPH诊断方法可能不能准确地反映实际的血液损失.
- 对PPH的低诊断可能导致延迟或不充分的管理.
研究的目的:
- 评估定量流血 (QBL) 和其与产后出血 (PPH) 诊断的相关性.
- 确定与PPH相关的临床,人口和住院因素.
- 在不同的分娩类型中,将估计的血液损失 (EBL) 与QBL进行比较.
主要方法:
- 九个月的交付时间的回顾性图表审查.
- 包括患者人口统计,PPH诊断,血液损失数据和住院变量.
- 使用EBL和QBL方法分析血液损失.
主要成果:
- 根据目前的美国指南,PPH在78%的病例中被诊断不足.
- 严重的PPH诊断不足发生在超过500-1000毫升的血液损失的情况下.
- 在阴道分娩中,EBL低估了输血,在剖腹产中高估了输血.
- 诊断PPH与更长的住院时间和医疗费用增加有关.
- 与高加索女性相比,非洲裔美国人和西班牙裔/拉丁裔女性的PPH率更高.
结论:
- 量化血液损失测量对于识别未被诊断的PPH病例至关重要.
- 在种族和民族之间存在PPH诊断的差异.
- 通过QBL改进PPH检测可以提高孕产妇的护理和结果.
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