陕西省麟游县孕产妇死亡监测结果分析

An analysis of screening results of maternal mortality in Linyou county

目的掌握麟游县孕产妇死亡率的动态变化、主要死亡原因和影响因素，评估孕产妇接受卫生保健服务效果。方法对县内所有长住及流动人口中的孕产妇死亡进行监测。结果1988～2007年全县孕产妇死亡率为141．99／10万，后10年（1998～2007年）比前10年（1988～1997年）孕产妇死亡率下降，但无统计学差异。近10年孕产妇分娩地点及死亡地点有显著性变化。可避免及创造条件可避免的孕产妇死亡占84．00％。孕产妇主要死亡原因为产后出血、妊娠高血压疾病及合并症。贫困、偏远、生活条件差、资源缺乏等为孕产妇死亡的主要影响因素。结论加强围产期保健，做好高危妊娠管理；加强各级产科建设，提高产科人员业务技能；加强健康教育，改变传统生育观念；开展贫困孕产妇救助工作，有效降低孕产妇死亡率。

Objective To investigate maternal mortality, major cause of maternal mortality and influencing factors in Linyou county, Shaanxi province, to evaluate effect of health care service of the pregnant and parturient women, Methods The maternal mortality in the county among permanent and migrant population was monitored. Results The maternal mortality rate in period from 1988 to 2007 in the county was 141.99/100 000. Of which, the maternal mortality rate in latter one decade（ 1998 -2007）was significantly lower than that in the former one decade（ 1988 - 1997）. The maternal delivery and death places changed greatly. Avoidable maternal mortality and avoidable maternal mortality after creating conditions accounted for 84.00% of the total in the two decades of period. The major causes of maternal mortality included postpartum hemorrhage, hypertensive disorder complicating pregnancy and complications of pregnancy. Poverty, remote districts, poor living conditions, deficiency in resources are all influential factors of maternal mortality. Conclusion In order to reduce the maternal mortality rate, firstly, perinatal health work should be strengthened and high-risk pregnant women should be managed properly. Secondarily, construction of different levels of obstetrical institution should be reinforced and professional skills of obstetricians should be raised. Thirdly, health education work should be strengthened and traditional ideas of reproduction should be changed. Finally, assistance work for those poor pregnant and parturient women should be conducted.