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Temporal Trends of Maternal Mortality Due to obstetric Hemorrhage in Chinese Mainland: Evidence from the Population-Based Surveillance Data Between 2000 and 2019

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Maternal-Fetal Medicine 2022年第3期4卷 169-178页

作者： Yi Mu Jun Zhu Yanping Wang Jiani Zhang Mingrong Li Peiran Chen Yanxia Xie Juan Liang Xiaodong Wang National Office for Maternal and Child Health Surveillance of China West China Second University HospitalSichuan UniversityChengdu 610041China Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University) Ministry of EducationChengdu 610041China Department of obstetrics and Gynecology West China Second University HospitalSichuan UniversityChengdu 610041China.

Objective:To analyze the temporal trends of maternal mortality ratio(MMR)due to obstetric hemorrhage and its specific causes in Chinese mainland from 2000 to 2019,to identify whether the rate of change has accelerated or slowed down during this period,and to find the prior cause of obstetric hemorrhage that needs to be intervened in the ***:Individual information on maternal deaths and total number of live births from 336 surveillance sites across 31 provinces in Chinese mainland was collected from the National Maternal and Child Health Surveillance System between 2000 and *** death was defined according to the World Health Organization’s *** final underlying cause of death was confirmed by the national review and was coded according to International Classification of *** trends for changes in characteristics of maternal deaths were assessed using linear or logistic models with the year treated as a continuous *** MMR and 95%confidence intervals(CI)for regions or causes were estimated by Poisson’s *** regression was used to assess the accurate temporal ***:The national MMR due to obstetric hemorrhage was 18.4 per 100,000 live births(95%CI:15.0–22.2)in *** peaked in 2001(22.1 per 100,000 live births,95%CI:18.3–26.4)and was lowest in 2019(1.6 per 100,000 live births,95%CI:1.0–2.3).For specific regions,the MMR due to obstetric hemorrhage in rural areas and western regions both experienced a slight rise,followed by a rapid decline,and then a slow *** specific causes,no change point was found in joinpoint analysis of the national MMR caused by placenta previa,postpartum uterine atony,and retained placenta(the annual percent change was12.0%,10.5%,and21.0%,respectively).The MMR caused by postpartum hemorrhages(PPH)significantly declined by 8.0%(95%CI:1.9–13.6)per year from 2000 to *** annual percent change of MMR caused by PPH accelerated further to25.0%between 2007

关键词： Maternal mortality obstetric haemorrhage Temporal trend Annual percent change China

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Diagnostic Performance of Serial bedside Capillary Lactate, Hemoglobin, and Shock Index for Severe Postpartum

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Advances in Reproductive Sciences 2021年第4期9卷 189-198页

作者： Roberto Arturo Castillo-Reyther Idelia Natalie Plata-Alcocer Salvador De la Maza-Labastida Venance Basil Kway Ma. del Pilar Fonseca-Leal Department of obstetrics and Gynecology Hospital Central Dr. Ignacio Morones Prieto San Luis Potosi Mexico Research and Clinical Postgraduate Department of the Faculty of Medicine Universidad Autonoma de San Luis Potosi Mexico

Objective: To assess the diagnostic capacity of bedside capillary lactate (CLact), capillary Haemoglobin (CHb), and shock index (SI) for severe postpartum haemorrhage (SPPH > 2000 ml) at diagnosis, 15 minutes and 30 minutes later. Method: A cohort study was carried out in a reference hospital in San Luis Potosi, Mexico from February 2020 to March 2021, and included sixty women in vaginal labor or c-section who presented PPH (≥500 ml in labor or ≥1000 ml in c-section) measured by the gravimetric method. CLact, SI, and CHb concentrations were analyzed at diagnosis of PPH, 15 minutes, and 30 minutes. Patients who presented total blood loss of >2000 ml were considered SPPH. A T-test or Wilcox test was performed to compare the groups of non-severe and severe. Sensitivity, specificity, and performance were calculated by A Receiver Operating Curve. Results: A CLact measurement at 30 minutes was significantly different between the non-severe and severe groups (4.0 + 1.9 vs 4.8 + 1.15 P-value 0.001, with an optimal cut point of 4.3 mmol/dl at AUC 0.75, sensitivity 0.85, and specificity of 0.62. With a cut-point of 1.17, an AUC of 0.76, sensitivity of 0.43, and specificity of 0.98, SI at diagnosis was significantly different between the non-severe and severe groups (0.70 + 0.20 vs. 0.90 + 0.38 P-value 0.0228). Conclusion: SI is an early sign of SPPH;CLact can significantly identify SPPH after 30 minutes.

关键词： Capillary Haemoglobin Lactate obstetric haemorrhage Shock Index

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