Severe Maternal(严重的产妇)研究综述
Severe Maternal 严重的产妇 - We examine these hospital-level factors and their association with severe maternal morbidity (SMM), independently and as effect modifiers of patient-level factors. [1] Background Current interest in using severe maternal morbidity (SMM) as a quality indicator for maternal healthcare will require the development of a standardized method for estimating hospital or regional SMM rates that includes adjustment and/or stratification for risk factors. [2] Background: The relationship between severe maternal morbidity (SMM) events during inpatient delivery and subsequent hospital readmission is not well understood. [3] OBJECTIVE To develop and validate a preconception risk prediction index for severe maternal morbidity (SMM), defined by the Centers for Disease Control and Prevention as indicators of a life-threatening complication, among infertile patients. [4] Background: Studies of obstetric quality of care have almost exclusively focused on severe maternal morbidity (SMM) and have rarely examined more common complications. [5] PURPOSE The goal of this study was to evaluate how rural/urban status and other risk factors alter women's odds of severe maternal morbidity (SMM) at delivery. [6] Severe maternal morbidity (SMM) is a composite outcome measure that indicates serious, potentially life-threatening maternal health problems. [7] Accreta placenta spectrum is a complex obstetrical condition of abnormal placental invasion associated with severe maternal morbidity. [8] To describe the clinical profile, management, maternal outcomes and factors associated with severe maternal outcome (SMO) in patients admitted for eclampsia. [9] This implies that severe maternal hypercholesterolemia during pregnancy is not associated with additional risk in the FH affected offspring. [10] OBJECTIVE Rising maternal mortality and severe maternal morbidity (SMM) rates have drawn increasing public health attention. [11] Primary outcome was the severe maternal morbidity composite defined by the Centers for Disease Control and Prevention. [12] 001), and severe maternal morbidity (5. [13] The issue reportedly has severe maternal and neonatal outcomes including mortality, and generally leads to a decreased satisfaction with maternity care. [14] Background Monitoring rates of severe maternal morbidity (such as eclampsia and uterine rupture) is useful to assess the quality of obstetric care, particularly in low and lower-middle-income countries (LMICs). [15] In this study, we compared the changes in the incidence of severe maternal morbidity (SMM) during delivery hospitalizations between low- and high-income women associated with the 2014 Medicaid expansion in New York State. [16] INTRODUCTION Despite increased attention on severe maternal morbidity and maternal mortality, scant research exists on adverse maternal outcomes in women with disabilities. [17] BACKGROUND Obstetric hemorrhage is a leading cause of severe maternal morbidity (SMM), a key indicator of a nation's health care delivery system and often associated with a high rate of preventability. [18] Results: There were 32,110 deliveries, 147 near miss cases and 12 MDs, resulting in maternal mortality ratio of 38/100,000 live birth (LB), severe maternal outcome ratio of 5/1000 LB and MNM ratio of 4. [19] Severe maternal morbidity (SMM) affects 50,000 women annually in the US, but its consequences are not well understood. [20] 1 times more likely to suffer from severe maternal morbidity, and three to four times more likely to die from childbirth complications when compared with their White counterparts. [21] Background: Preterm premature rupture of membranes (PPROM) impacts on approximately 3 percentage of pregnancies and is linked with severe maternal problems, resulting in, significant neonatal mortality and morbidity. [22] This study aims to provide insights in the perspectives of women with severe maternal morbidity on preparedness, access and quality of care in Zanzibar’s referral hospital. [23] OBJECTIVE Rates of severe maternal morbidity (SMM) are significantly higher among Black women and some data suggests further worsening of these rates among hospitals with the highest proportion of Black deliveries. [24] The complications of cesarean scar pregnancy are uterine rupture, massive haemorrhage, need for hysterectomy and risk of severe maternal morbidity and mortality. [25] Background While there is a global focus on severe maternal morbidity (SMM), less is known about the impact of SMM on fetal and neonatal outcomes. [26] 22], severe maternal morbidity during pregnancy AOR 4. [27] BACKGROUND The consequences of an infertility diagnosis extend beyond the pursuit of family building, as infertile women also face increased risks of severe maternal morbidity, cancer, and chronic disease. [28] Objective To evaluate the impact of a hemorrhage quality-improvement collaborative on racial disparities in severe maternal morbidity from hemorrhage. [29] OBJECTIVE To examine long-term risks of mortality after a pregnancy complicated by severe maternal morbidity. [30] Key Points Question What is the risk of severe maternal morbidity or mortality in women with a preexisting disability compared with women without disabilities? Findings This population-based cohort study evaluated more than 1. [31] This is the largest reported series of obstetric outcomes for CHMCF, and highlights the need to counsel patients about the severe maternal and fetal complications in continuing pregnancies, including progression to gestational trophoblastic neoplastic disease. [32] Objective: To estimate the incidence rate and associated risk factors of severe maternal morbidity (SMM) in commercially and Medicaid-insured women. [33] The outcomes were 1) severe maternal morbidity (SMM) with and without transfusion, in accordance with the Centers for Disease Control and Prevention's definition; and 2) neonatal morbidity, defined using The Joint Commission's Perinatal Quality metric of moderate and severe unexpected newborn complications (UNCs) among term, singleton, non-anomalous neonates. [34] BACKGROUND Pregnant women with a substance-related diagnosis, such as alcohol use disorder, are a vulnerable population who may be experiencing disproportionate rates of severe maternal morbidity, such as hemorrhage and eclampsia, compared to pregnant women without a substance-related diagnosis. [35] Objective To compare the prognostic validity of the APACHE II-M and O-SOFA scales versus the APACHE II and SOFA to predict mortality in patients with severe maternal morbidity. [36] (5) According to a literature review on uterine rupture in developing countries, the proportion of women with prior CS or uterine scar among women who had uterine rupture was up to 64% (6) Though a rare complication uterine rupture is associated with severe maternal and neonatal morbidity and mortality. [37] The incidence of severe maternal adverse events was also higher (32. [38] Methods of study selection Selection criteria included studies examining associations between social determinants and adverse maternal outcomes including pregnancy-related death, severe maternal morbidity, and emergency hospitalizations or readmissions. [39] In conclusion, expectant management in women with PPROM during the late preterm period does not increase the risk of severe maternal and neonatal morbidities and mortality; however, careful monitoring for chorioamnionitis or fetal compromise should be considered during expectant management. [40] Drug ineffectiveness and drug exposure during the third trimester of pregnancy: case report In a retrospective, cohort study of 59 women with severe preeclampsia, who were admitted and delivered at a hospital in Italy between January 2015 and December 2018, a 40-year-old woman was described, who experienced ineffectiveness during treatment sodium chloride for severe maternal hyponatraemia during the third trimester of pregnancy. [41] 39 Influenza in pregnancy and severe maternal morbidity in the United States, 2000-2015 Timothy Wen, Brittany Arditi, Laura E. [42] Maternal mortality and severe maternal morbidity are urgent issues in the United States. [43] It is not known whether blunted glomerular hyperfiltration leads to adverse maternal outcomes, including severe maternal morbidity (SMM). [44] Avoiding moderate to severe maternal injuries is a high priority for saving the fetus, and education on appropriate seatbelt use and limiting vehicle speed for pregnant women is required. [45] The primary measure of outcome was severe maternal outcome. [46] Placenta accreta spectrum (PAS) is a condition often resulting in severe maternal morbidity. [47] OBJECTIVE To assess the incidence of Severe Maternal Outcome (SMO), comprising maternal mortality (MM) and near miss (MNM), in Metro East healthdistrict, Western Cape Province, South Africa between November 2014 and November 2015 and identify associated determinants leading to SMO with the aim to improve maternity care. [48] Most studies have focused on mildly affected populations, but less is known about the effect of severe maternal psychopathology. [49] There is no significant difference in severe maternal complications between the two groups. [50]我们检查这些医院层面的因素及其与严重孕产妇发病率 (SMM) 的关联，独立地和作为患者层面因素的影响修饰符。 [1] 背景 目前对使用严重孕产妇发病率 (SMM) 作为孕产妇保健质量指标的兴趣需要开发一种标准化方法来估计医院或区域 SMM 率，包括对风险因素进行调整和/或分层。 [2] 背景：住院分娩期间的严重产妇发病率 (SMM) 事件与随后的再入院之间的关系尚不清楚。 [3] 客观的 开发和验证严重孕产妇发病率 (SMM) 的孕前风险预测指数，该指数由疾病控制和预防中心定义为不孕患者中危及生命的并发症的指标。 [4] 背景：产科护理质量的研究几乎完全集中在严重的产妇发病率（SMM）上，很少检查更常见的并发症。 [5] 目的 本研究的目的是评估农村/城市状况和其他风险因素如何改变妇女在分娩时发生严重孕产妇发病率 (SMM) 的几率。 [6] 严重孕产妇发病率 (SMM) 是一项综合结果指标，表明严重的、可能危及生命的孕产妇健康问题。 [7] 植入性胎盘谱是一种复杂的产科疾病，异常胎盘侵入与严重的产妇发病率相关。 [8] 描述因子痫入院的患者的临床概况、管理、母亲结局和与严重母亲结局 (SMO) 相关的因素。 [9] 这意味着怀孕期间严重的母体高胆固醇血症与受 FH 影响的后代的额外风险无关。 [10] 客观的 不断上升的孕产妇死亡率和严重孕产妇发病率 (SMM) 引起了越来越多的公共卫生关注。 [11] 主要结果是疾病控制和预防中心定义的严重孕产妇并发症。 [12] 001) 和严重的孕产妇发病率 (5. [13] 据报道，该问题具有严重的孕产妇和新生儿后果，包括死亡率，并且通常会导致对孕产妇保健的满意度下降。 [14] 背景 监测严重孕产妇发病率（如子痫和子宫破裂）有助于评估产科护理的质量，尤其是在低收入和中低收入国家 (LMIC)。 [15] 在这项研究中，我们比较了与 2014 年纽约州医疗补助计划扩张相关的低收入和高收入妇女分娩住院期间严重孕产妇发病率 (SMM) 的变化。 [16] 介绍 尽管对严重孕产妇发病率和孕产妇死亡率的关注日益增加，但对残疾妇女的不良孕产妇结局的研究很少。 [17] 背景 产科出血是严重孕产妇发病率 (SMM) 的主要原因，它是一个国家医疗保健提供系统的关键指标，通常与高预防率相关。 [18] 结果：共有 32,110 例分娩，147 例未遂病例和 12 例 MD，导致孕产妇死亡率为 38/100,000 活产（LB），严重孕产妇结局比为 5/1000 LB，MNM 比为 4。 [19] 在美国，每年有 50,000 名妇女受到严重孕产妇疾病 (SMM) 的影响，但其后果尚不清楚。 [20] 与白人同行相比，患严重孕产妇疾病的可能性高出 1 倍，死于分娩并发症的可能性高出 3 到 4 倍。 [21] 背景：早产胎膜早破 (PPROM) 影响大约 3% 的妊娠，并与严重的孕产妇问题有关，导致新生儿死亡率和发病率显着增加。 [22] 本研究旨在从桑给巴尔转诊医院的孕产妇严重发病率妇女的准备、可及性和护理质量方面提供见解。 [23] 客观的 黑人妇女的严重孕产妇发病率（SMM）明显更高，一些数据表明，在黑人分娩比例最高的医院中，这些发病率进一步恶化。 [24] 剖宫产疤痕妊娠的并发症 子宫破裂、大出血、需要进行子宫切除术以及孕产妇严重发病和死亡的风险。 [25] 背景 虽然全球都关注严重孕产妇发病率 (SMM)，但对 SMM 对胎儿和新生儿结局的影响知之甚少。 [26] 22]，怀孕期间严重的产妇发病率 AOR 4。 [27] 背景 不孕症诊断的后果超出了追求家庭建设的范围，因为不孕妇女还面临着严重的孕产妇发病率、癌症和慢性病的风险增加。 [28] 目的评估出血质量改善协作对严重产妇出血致死率的种族差异的影响。 [29] 客观的 检查妊娠合并严重孕产妇并发症后的长期死亡风险。 [30] 要点 问题 与没有残疾的妇女相比，有残疾的妇女发生严重孕产妇发病或死亡的风险是多少？结果 这项基于人群的队列研究评估了超过 1 个。 [31] 这是关于 CHMCF 的最大系列产科结果报告，并强调需要向患者提供关于持续妊娠中严重母婴并发症的咨询，包括进展为妊娠滋养细胞肿瘤疾病。 [32] 目的：评估商业和医疗补助保险妇女的严重孕产妇发病率 (SMM) 的发病率和相关危险因素。 [33] 结果是 1) 根据疾病控制和预防中心的定义，有和没有输血的严重孕产妇发病率 (SMM)； 2) 新生儿发病率，使用联合委员会的围产期质量指标来定义足月、单胎、非异常新生儿的中度和重度意外新生儿并发症 (UNC)。 [34] 背景 与没有物质相关诊断的孕妇相比，患有物质相关诊断（例如酒精使用障碍）的孕妇是弱势群体，她们可能经历不成比例的严重孕产妇发病率，例如出血和子痫。 [35] 目的比较 APACHE II-M 和 O-SOFA 量表与 APACHE II 和 SOFA 量表在预测严重产妇发病率患者死亡率方面的预后有效性。 [36] （5）根据一篇关于发展中国家子宫破裂的文献回顾，在有子宫破裂的妇女中，既往有 CS 或子宫瘢痕的妇女比例高达 64%（6）虽然罕见的并发症子宫破裂与严重的产妇有关和新生儿发病率和死亡率。 [37] 严重孕产妇不良事件的发生率也较高（32. [38] 研究选择方法 选择标准包括研究社会决定因素与不良孕产妇结局之间的关联，包括妊娠相关死亡、严重孕产妇发病率和紧急住院或再入院。 [39] 总之，早产晚期 PPROM 女性的期待治疗不会增加严重的孕产妇和新生儿发病率和死亡率的风险；然而，在期待治疗期间应考虑仔细监测绒毛膜羊膜炎或胎儿损害。 [40] 妊娠晚期药物无效和药物暴露：病例报告 在一项对 2015 年 1 月至 2018 年 12 月期间在意大利一家医院入院和分娩的 59 名重度先兆子痫妇女的回顾性队列研究中，一名 40 岁的妇女描述了一名妇女，她在妊娠晚期因严重的母体低钠血症而在氯化钠治疗期间无效。 [41] 39 美国妊娠期流感和严重孕产妇发病率，2000-2015 年 Timothy Wen、Brittany Arditi、Laura E. [42] 孕产妇死亡率和严重孕产妇发病率是美国的紧迫问题。 [43] 目前尚不清楚肾小球超滤迟钝是否会导致不良母体结局，包括严重的母体发病率 (SMM)。 [44] 避免中度至重度产妇伤害是挽救胎儿的重中之重，需要对孕妇进行正确使用安全带和限制车速的教育。 [45] 结果的主要衡量标准是严重的孕产妇结局。 [46] 胎盘植入谱 (PAS) 是一种经常导致严重产妇发病率的疾病。 [47] 客观的 评估 2014 年 11 月至 2015 年 11 月期间南非西开普省 Metro East 卫生区的严重孕产妇结局 (SMO) 发生率，包括孕产妇死亡率 (MM) 和未遂事故 (MNM)，并确定导致 SMO 的相关决定因素旨在改善产妇保健。 [48] 大多数研究都集中在轻度受影响的人群上，但对严重母体精神病理学的影响知之甚少。 [49] 两组产妇严重并发症无显着差异。 [50]
intensive care unit
Patients were divided into three cohorts: Group A, patients with infection but without severe maternal outcomes (SMO); Group B, patients with infection and SMO or admission to the intensive care unit (ICU); and Group C, a control group. [1] Costs were significantly different between groups based on gestational age and mode of delivery, and with severe maternal morbidity and neonatal intensive care unit admission status (p<. [2] Interventions (induction, artificial rupture of membranes, epidural, oxytocin, and episiotomy), mode of delivery, maternal outcomes (third- or fourth-degree laceration, postpartum hemorrhage, blood transfusion, and severe maternal morbidity), and newborn outcomes (shoulder dystocia, 5-minute Apgar score less than 7, resuscitation at delivery, birth trauma, and neonatal intensive care unit admission) were examined by practitioner type. [3] Obstetric intensive care unit (ICU) admissions comprise only a small part of severe maternal morbidity. [4]患者被分为三组：A组，感染但没有严重母体结局（SMO）的患者； B组，感染和SMO或入住重症监护病房（ICU）的患者； C组，对照组。 [1] 根据胎龄和分娩方式，以及严重的孕产妇发病率和新生儿重症监护病房的入院情况，各组的费用存在显着差异（p<. [2] nan [3] nan [4]
outcomes included growth
Secondary outcomes included growth restriction, neonatal morbidity (in the first 30 days) and severe maternal morbidity (SMM) as defined by the CDC. [1] Secondary outcomes included growth restriction, fetal demise, neonatal morbidity (any of the following: need for respiratory support within 72 hours of life, hypoxic-ischemic encephalopathy, seizure, sepsis/pneumonia, meconium aspiration syndrome, birth trauma, and intracranial or subgaleal hemorrhage), and severe maternal morbidity (SMM) as defined by the CDC. [2] Secondary outcomes included growth restriction, neonatal morbidity, stillbirth, cesarean delivery, and severe maternal morbidity. [3]次要结局包括 CDC 定义的生长受限、新生儿发病率（前 30 天）和严重孕产妇发病率 (SMM)。 [1] 次要结局包括生长受限、胎儿死亡、新生儿发病率（以下任何一项：出生后 72 小时内需要呼吸支持、缺氧缺血性脑病、癫痫发作、败血症/肺炎、胎粪吸入综合征、产伤和颅内或帽状腱膜下出血） ) 和 CDC 定义的严重孕产妇发病率 (SMM)。 [2] nan [3]
adjusted odds ratio
Severe maternal morbidity (adjusted odds ratio (aOR) 4. [1] We found increased odds for severe maternal outcomes among women enrolled during the post-partum or post-abortion period from facilities located in low-income countries (adjusted odds ratio 1·84 [95% CI 1·05–3·22]) and among women enrolled during pregnancy or childbirth from non-urban facilities (adjusted odds ratio 2·44 [1·02–5·85]). [2]严重的孕产妇发病率（调整优势比 (aOR) 4. [1] 我们发现，在产后或流产后从低收入国家的机构登记的女性中，出现严重孕产妇结局的几率增加（调整后的优势比 1·84 [95% CI 1·05-3·22]）和在怀孕或分娩期间从非城市设施登记的女性中（调整优势比 2·44 [1·02–5·85]）。 [2]