351例重症孕产妇转诊病种和结局分析

351 Cases Analysis of Transferred Severe Pregnancy Complications and the Outcomes

目的：通过对351例重症孕产妇转诊资料进行分析,了解转诊病种分布和母儿结局,并总结转诊经验。方法：回顾性分析2009年1-12月转诊入重庆医科大学附属第一医院的重症孕产妇351例患者的临床资料,统计分析患者转诊医院、病种分布以及母儿预后等指标。结果：①转诊医院为二级医院所占比例最大（80.9%）;②病种分布依次为：重度子痫前期（23.4%）,胎膜早破（17.9%）,先兆早产（17.7%）,中央性前置胎盘（13.1%）,妊娠期肝内胆汁淤积症（10.0%）;③母儿结局：1例产妇死亡,其余350例患者均痊愈出院;其中孕妇引产放弃胎儿29例（9.0%）,阴道分娩32例（9.9%）,剖宫产261例（91.1%）;326例活产新生儿,死亡3例（0.9%）,转新生儿重症监护室（NICU）162例（49.7%）,其中早产142例,新生儿窒息10例,新生儿肺炎8例,新生儿黄疸2例。结论：重症孕产妇转诊与规范化救治是降低孕产妇和围生儿死亡率的关键,应努力构建统筹城乡的重症孕产妇转诊网络和提高救治能力。

Objective:To analyze the clinical data of 351 cases of transferred severe pregnancy complications,to investigate the distribution of maternal diseases and the therapeutic outcomes,thus to gain the experience of transfering patients.Methods:Retrospective analysis was done on 351 cases of transfered severe pregnancy complications to Chongqing medical university first affiliated hospital from Jan.2009 to Dec.2009.The transfering hospital,distribution of disease,maternal and fetal outcomes were analyzed.Results:① 80.9%.of the transfering hospitals were Grade-Ⅱ hospital.② The distribution of the diseases was severe pre-eclampsia(23.4%),premature rupture of membranes(17.9%),threatened premature delivery(17.7%),central placenta previa(13.1%),intrahepatic cholestasis of pregnancy(10.0%).③ One patient died,and 350 patients were survived.29(9.0%) pregnant women gave up the fetus to choose induction,32(9.9%) cases were vaginal delivery and 261(91.1%) cases were cesarean section.326 live babies were gained and 3(0.9%)babies died,162(49.7%)babies were transferred to NICU,which included 142 cases of preterm,10 cases of asphyxia,8 cases of neonatal pneumonia,and 2 cases of neonatal jaundice.Conclusions:Emergency referral and standard treatment of severe pregnancy complications play important roles in reducing the maternal and perinatal mortality.Construction of urban and rural transfering network and improving hospital therapy enviroment should be done.