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期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-03069-5

摘要内容如下：

及时发现和治疗产后出血（PPH）是预防并发症或死亡的关键。校准的采血单可以帮助提供客观、准确和早期的PPH诊断，治疗组合可以解决有效干预措施使用中的延迟或不一致。在这里，我们进行了一项与E-MOTIVE试验同时进行的经济评估，E-MOTIVE试验是一项国际平行集群随机试验，基线控制阶段涉及肯尼亚、尼日利亚、南非和坦桑尼亚78家二级医院的210，132名阴道分娩妇女。我们旨在评估E-Motive干预的成本效益，与常规护理相比，E-Motive干预包括用于PPH早期检测的校准采血巾和一系列第一反应治疗（子宫按摩、催产素药物、氨甲环酸、静脉输液、检查和升级）。我们使用多水平模型，从公共医疗系统的角度来估计增量成本效益比，以避免每严重产后出血（失血量≥1，000ml）的成本和避免每残疾调整生命年的成本。我们的研究结果表明，使用校准的采血单进行PPH的早期检测和捆绑的第一反应治疗是具有成本效益的，并且应被决策者视为值得使用的医疗保健预算。ClinicalTrials.gov标识符：NCT04341662。

英文原文如下：

Abstracts

Timely detection and treatment of postpartum hemorrhage (PPH) are crucial to prevent complications or death. A calibrated blood-collection drape can help provide objective, accurate and early diagnosis of PPH, and a treatment bundle can address delays or inconsistencies in the use of effective interventions. Here we conducted an economic evaluation alongside the E-MOTIVE trial, an international, parallel cluster-randomized trial with a baseline control phase involving 210,132 women undergoing vaginal delivery across 78 secondary-level hospitals in Kenya, Nigeria, South Africa and Tanzania. We aimed to assess the cost-effectiveness of the E-MOTIVE intervention, which included a calibrated blood-collection drape for early detection of PPH and a bundle of first-response treatments (uterine massage, oxytocic drugs, tranexamic acid, intravenous fluids, examination and escalation), compared with usual care. We used multilevel modeling to estimate incremental cost-effectiveness ratios from the perspective of the public healthcare system for outcomes of cost per severe PPH (blood loss ≥1,000 ml) avoided and cost per disability-adjusted life-year averted. Our findings suggest that the use of a calibrated blood-collection drape for early detection of PPH and bundled first-response treatment is cost-effective and should be perceived by decision-makers as a worthwhile use of healthcare budgets. ClinicalTrials.gov identifier: NCT04341662 .

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