Risk factors of obstetric admissions to the intensive care unit

Lin, Lin; Chen, Yanhong; Sun, Wen; Gong, Jingjin; Li, Pu; Chen, Juanjuan; Hao, Yan; Ren, Lihua; Chen, Dunjin

doi:10.1097/md.0000000000014835

Cited by 17 publications

(22 citation statements)

References 22 publications

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“…With the progress of urbanization and the regional characteristics of Yangzhou, the rural population still occupies a considerable proportion. The migrant population with unstable income and lacking medical insurance has also increased overwhelmingly [25]. The government and health institutions should strengthen health education for the migrant population, raise awareness of self-health management, and gradually realize that migrant women enjoy the same health care services as the place where they immigrated .This solution can promote the conversion of a high-risk pregnancy to medium or low risk and effectively reduce the occurrence of MNM.…”

Section: Discussionmentioning

confidence: 99%

Incidence, risk factors, and causes of maternal near-miss admitted to the intensive care unit in Yangzhou, China: A 5-year retrospective study

Chen¹,

Shi²,

Zhu³

et al. 2020

Preprint

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BackgroundThe maternal near-miss (MNM) criterion formulated by the WHO can dynamically evaluate the obstetric quality and maternal health in medical institutions. The study aims to explore the incidence, risk factors, and causes of MNM cases admitted to the intensive care unit (ICU) within 5 years.MethodsThis study is a retrospective study. The data of MNM admitted to the ICU comes from the medical records of Subei People's Hospital in Yangzhou from 2015 to 2019. The study subjects meet at least one World Health Organization (WHO) criterion of MNM. The MNM who had not been admitted to the ICU in the same year served as the control group. We use descriptive analysis, Chi-Square test and Fisher’s exact test for data analysis.Results151 women met the WHO criteria of MNM and there was one maternal death in 2016. The average maternal near-miss rate（MNMR）for ICU admission was 3.5 per 1,000LBs, and the average MNM morbidity was 0.36%. The average maternal mortality ratio (MMR) was 5 per 100,000LBs. The 5-year research period witnessed moderate growth in MNM admitted to the ICU. The region, referral, gravidity, prenatal examination, and mode of delivery were significantly related to the MNM admitted to the ICU(p<0.05). Concerning neonatal characteristics, there is a significant difference in preterm birth rate and low Apgar scores at 1 min and 5 min(p<0.05). The direct obstetric causes were the primary cause of MNM, regardless of the ICU admission. The leading direct obstetric causes of MNM admitted to the ICU were obstetric hemorrhage diseases(38.8%)，following hypertension diseases(18.8%), while the leading indirect obstetric cause of MNM admitted to the ICU was heart-related diseases (7.2%). MNM for the ICU admission were mostly postpartum (96.9%), who underwent multiple interventions.ConclusionsICU is one of the most important endpoints of MNM management. In the context of "universal two-child", medical institutions should strengthen multidisciplinary joint treatment. In the future, it needs to be expanded to multi-center research to determine the criteria for MNM admitted to the ICU.

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Section: Discussionmentioning

confidence: 99%

Incidence, risk factors, and causes of maternal near-miss admitted to the intensive care unit in Yangzhou, China: A 5-year retrospective study

Chen¹,

Shi²,

Zhu³

et al. 2020

Preprint

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“…Uterine atony, or lack of effective contraction of the uterus, is the most common cause of PPH 3followed by infection, subinvolution of the placental site, and inherited coagulation deficits (14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Digital Postpartum Hemorrhage Management Device (DPHMD)

Tekela

Asmare

Gebremariam

et al. 2019

Preprint

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Background Primary postpartum hemorrhage (PPH) is an obstetric emergency caused by excessive blood loss that occurs most commonly after the placenta is delivered. PPH can lead to volume depletion, hypovolemic shock, anemia, and it is the leading cause of maternal mortality worldwide. With 470 deaths per 100,000 live births, the maternal mortality ratio in Ethiopia is one of the highest in the world. It is estimated that 94% of births occur at home in Ethiopia and that 10% of maternal deaths are attributed to PPH. Currently, physicians use visual estimation to calculate blood loss and provide fluid during delivery. This traditional method is subjective and generally inaccurate.Method In this project, after delivery blood loss measurement system integrated with fluid delivery and vital sign monitoring method is proposed. The collection and measurement system collects blood loss after delivery and measures the amount of blood loss. The management system continuously monitors the mother’s heart rate and blood pressure. These vital sign values are integrated with the measured blood loss to estimate the amount of IV fluid required to be delivered for the mother. The rate of IV fluid delivery is regulated by a flow rate sensor and solenoid valve.Results The prototype was built and undergone through different tests and iterations. The proposed device was tested for accuracy, cost effectiveness and ease to use. 91.28% accuracy has been achieved and the prototype was built with less than 210 USD.Conclusion The proposed design allows physicians, especially those in low resource setting, to estimate blood loss and deliver fluid accurately. This helps to reduce maternal mortality rate that may occur due to postpartum hemorrhage.

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Section: Introductionmentioning

confidence: 99%

Digital Postpartum Hemorrhage Management Device (DPHMD)

Dereje

Getachew

Meskelu

et al. 2019

Preprint

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Background Primary postpartum hemorrhage (PPH) is an obstetric emergency caused by excessive blood loss that occurs most commonly after the placenta is delivered. PPH can lead to volume depletion, hypovolemic shock, anemia, and it is the leading cause of maternal mortality worldwide. Maternal mortality ratio in Ethiopia is among the highest in the world with 470 deaths per 100,000 live births. 94% of births in Ethiopia are estimated to occur at home and 10% of maternal deaths are attributed to PPH. Currently, physicians use visual estimation to calculate blood loss and provide fluid during delivery. This traditional method is subjective and generally inaccurate.Method In this project, after delivery blood loss measurement system integrated with fluid delivery and vital sign monitoring method is proposed. The collection and measurement system collects blood loss after delivery and measures the amount of blood loss. The management system continuously monitors the mother’s heart rate and blood pressure. These vital sign values are integrated with the measured blood loss to estimate the amount of IV fluid required to be delivered for the mother. The rate of IV fluid delivery is regulated by a flow rate sensor and solenoid valve.Results The prototype was built and undergone through different tests and iterations. The proposed device was tested for accuracy, cost effectiveness and ease to use. 91.28% accuracy has been achieved and the prototype was built with less than 210 USD.Conclusion The proposed design allows physicians, especially those in low resource setting, to estimate blood loss and deliver fluid accurately. This helps to reduce maternal mortality rate that may occur due to postpartum hemorrhage.

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Risk factors of obstetric admissions to the intensive care unit

Cited by 17 publications

References 22 publications

Incidence, risk factors, and causes of maternal near-miss admitted to the intensive care unit in Yangzhou, China: A 5-year retrospective study

Incidence, risk factors, and causes of maternal near-miss admitted to the intensive care unit in Yangzhou, China: A 5-year retrospective study

Digital Postpartum Hemorrhage Management Device (DPHMD)

Digital Postpartum Hemorrhage Management Device (DPHMD)

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