Maternal and Neonatal Outcomes of Hospital Deliveries in Lhasa, Tibet
Rommelmann, V. L. (2005, December). Maternal and Neonatal Outcomes of Hospital Deliveries in Lhasa, Tibet. Presented at American Public Health Association Annual Meeting, Philadelphia, PA.
Background: Maternal and neonatal morbidity and mortality rates are high in Tibet. Some hypothesize that women delivering at high altitude have higher pre-eclampsia, and/or hemorrhage rates than women delivering at low altitudes.
Methods: To better understand Tibetan birth outcomes, we conducted an observational study of women (n = 858) delivering vaginally at three hospitals in Lhasa between January and October 2004. Trained providers recorded data on labor, delivery, medications, and maternal and neonatal outcomes, including measured postpartum blood loss, using a closed-end blood collection drape.
Results: Mean postpartum blood loss was 276 ml (SD = 200 ml) median blood loss = 200 ml. Twelve percent met the definition of PPH (measured blood loss > 500 ml); 2% had blood loss > 1000 ml. Mean blood loss decreased across the study period. There were no maternal deaths. Maternal complications included: pre-eclampsia (3%), eclampsia (0.1%), and sepsis (3%). Major neonatal complications (23% overall) were asphyxia (11%) and prematurity (2%). Eighty-six babies were LBW (
Conclusions: The incidence of PPH and pre-eclampsia in women at 12,000 feet is similar to that of US women who live at much lower altitudes. The high frequency of neonatal complications appeared to be related to birth asphyxia. However, these outcomes may not be representative of women delivering at home. Further research on out of hospital deliveries in Tibet remains necessary.