The Current Situatiom,Prevention and Treatment Capabilities of Severe Post-partum Hemorrhage in Chinese Midwifery Institutions
Objective:To analyze the current situation,changing trends,and institutional variations of severe postpartum hemorrhage(SPPH)in China,in order to evaluate the prevention and treatment capabilities of SPPH in midwifery institutions in China.Methods:We used hospital-level annually aggregated data from hospitals across mainland China from the National Clinical Improvement System(NCIS).This study included 3871,4034,4028,4683 and 5277 maternity hospitals that reported complete data of obstetric indicators from 2018-2022.Calculate the SPPH rate(bleeding≥1000 ml within 24 hours after delivery),the SPPH related blood transfusion rate,and pregnancy related hysterectomy rate in different regions and categories of midwifery institutions across the country over the years.Data from 2022 were used to,describe the degree of variation of the above indicators in midwifery institutions across regions and institutions using the difference between P5 and P95.Results:Among the included midwifery institutions,the rates of SPPH and pregnancy-related hysterectomy decreased from 0.95%,35.91/100000 in 2018 to 0.94%,34.18/100000 in 2019,but the SPPH related blood transfusion rate remain relatively stable(0.62%)during 2018 and 2019.Subsequently,the rates of SPPH,blood transfusion caused by SPPH,and pregnancy-related hysterectomy increased to 0.99%,0.67%,and 36.34/100000 in 2020 respectively;then de-creasedagainfor two consecutive years in 2021(0.93%,0.62%,29.00/100000)and 2022(0.90%,0.59%,27.34/100000),allof whichwerelower thanthelevelsin2018.Thedatafor2022 shows that the SPPH related blood transfusion rate among tertiary(2.86%,1.92%)and secondary(2.55%,1.65%)public comprehensive hospitals have the highest degree of variation(difference between P5 and P95),while the SPPH rate(1.30%),SPPH related blood transfusion rate(0.73%),and pregnancy related hysterectomy rate(39.89/100000)in the southwest region are all at the highest level.Conclusions:The SPPH prevention and control capabilities of mid-wifery institutions in China continue to improve,but further promotion of homogeneous development between re-gions and institutions is still needed,especially focusing on improving the capabilities of western regions and pri-mary medical institutions.In the future,it is still necessary to explore comprehensive management strategies for the prevention and treatment of SPPH,and to implement systematic measures to improve the quality and efficien-cy of medical services to ensure the safety of pregnant and postpartum women,as direct obstetric causes gradu-ally shift to indirect obstetric causes in China.
万方数据
维普
