郴州市2000-2006年孕产妇死亡监测结果分析

Analysis of Maternal Mortality in Chenzhou City from 2000 to 2006

目的了解郴州市孕产妇死亡原因和影响因素。方法对郴州市11个县市区2000-2006年的死亡孕产妇进行连续动态监测,并逐例调查、核实、评审和分析。结果2000-2006年全市监测孕产妇死亡131例,年平均孕产妇死亡率为43.38/10万;城市5例,农村126例;以初中及以下文化程度为多,占93.89%;87.02%的孕产妇死亡发生在分娩后,产后24h内死亡占83.33%;28.95%在家中分娩;10.69%死亡在送往医院途中;31.3%未接受过产前保健;死亡的主要原因是直接产科原因,占83.9%,其中前三位死亡原因依次为产科出血,羊水栓塞,妊娠高血压病;评审结果可避免死亡为主,占72.52%。结论受教育程度低,居住环境偏僻,基层产科条件差、技术弱,孕期保健意识差,住院分娩率低是影响郴州市孕产妇死亡的主要因素。

Objective To study the cause and the influencing factors of pregnant and parturient women＇ s death in Chenzhou City. Methods The maternal mortalities in 11 counties and prefectures of Chenzhou City were monitored continuously with dynamic method. Every case had been investigated, verified, estimated and analyzed. Results A total of 131 pregnant and parturient women died in their perilabor and delivery period in Chenzhou City from 2000 to 2006. The average annual maternal mortality rate was 43.38/100,000. Five cases occurred in the city, and 126 cases in the country side. Most of the fatal cases were lowly educated which accounted for 93.89%, 87.02% maternal deaths occurred after labor, 83.33% deaths occurred within 24 - hour postdelivery, 28.95 % died at their home during the course of parturition, and 10.69 % died on the route of transferring into hospital. Among them, 31.3 % received no predelivery care. The direct obstetric events were the main cause of death, which accounted for 83.9 %. Obstetric hemorrhage, amnioticfluid embolism, pregnancy - induced hypertension were the main causes which resulted in maternal death. The review suggested 75.52 % deaths could be avoidable. Conclusion Factors affecting the maternal mortality are education level, living environment, socioeconomic condition, suboptimal technique of the village hospitals, health care consciousness of pregnancy, and low rate of hospital - delivery.