江永县1981～2009年孕产妇死亡分析

Analysis of maternal death status from 1981 to 2009 in Jiangyong County

目的:通过对江永县28年孕产妇死亡分析,找出孕产期保健与产科处理上的薄弱环节和存在的主要问题,针对死亡原因,提出干预措施,进一步降低孕产妇死亡率。方法:收集江永县1981～2009年活产总数98720名,孕产妇死亡63例;采用个案回顾性研究,总结分析28年来本县孕产妇死亡原因、死亡地点等情况。结果:28年中江永县孕产妇总死亡率为63.81/100000,近年来有下降的趋势,但不稳定。经专家评审可避免死亡26例,占41.27%;创造条件可避免死亡21例,占33.33%;不可避免死亡16例,占25.4%;孕产妇死亡顺位为产科出血(占44.44%)、妊娠合并高血压综合征、妊娠合并内科疾病(心脏病、肝脏病)。结论:加强孕产期保健管理,尤其是计划外妊娠的管理,采取多种措施,提高住院分娩率,加强高危妊娠管理和一次转诊到位,提高县级孕产妇急救中心急救能力,是降低孕产妇死亡率的有效措施。

Objective： To analyze of maternal death status in Jiangyong County from 1981 to 2009, and to find the weaknesses and deal with the main problems for the cause of death, proposed interventions to further reduce maternal mortality. Methods： Collected the report of dead pregnant women in Jiangyong County from 1981 to 2009, the number of live births was 98 720, the maternal mortality was 63. The death cause and place of death status etc were analyzed through reviewing of representative cases. Results： The total maternal mortality was 63.81/100 000 in Jiangyong County in 28 years, there was a downward trend in recent years, but unstable. The 26 peer-reviewed avoidable to be death, accounting for 41.27%; create conditions to prevent 21 deaths, accounting for 33.33%; the inevitable death of 16 people, accounting for 25.4%; maternal pick was obstetric hemorrhage （about 44.44%）, pregnancy-induced hypertension （PIH）, pregnancy with medical disease （heart disease, liver disease）. Conclusion： Strengthening maternal health care management, especially the unplanned pregnancy management, to take various measures to improve hospital delivery rate and enhance the high-risk pregnancy management and a referral in place to improve the level of county emergency center emergency ability, they are the effective measures to reduce the maternal mortality rate.