上海市妊娠风险预警评估管理模式初探

Primary study of pregnancy risk precaution and assessment management system in Shanghai

目的:分析上海市开展妊娠风险预警评估管理的实施情况和初步效果,发现存在的问题,并提出改进建议。方法:通过文献查阅和专家论证制定《妊娠风险预警评估筛查表》、《妊娠风险预警评估分类表》以及分级管理方案,并收集分析方案实施后半年的相关个案和报表以及现场问卷调查资料。结果:全市2010年1～6月使用《妊娠风险预警评估筛查表》后发现阳性孕妇17 069名,初次筛查阳性率22.3%;使用《妊娠风险预警评估分类表》后,疾病确诊10 382人,确诊率65%,其中高风险(红、橙、紫色)孕妇占6.6%,发现17例不宜继续妊娠孕妇并及时进行引产或剖宫产终止妊娠,从而直接避免了这些极有可能发生的孕产妇死亡。结论:妊娠风险预警评估管理实施以来取得初步成效,尤其孕产妇死亡率得到有效控制。但是方案还需进一步细化,急需促进信息平台的建设有利于提高管理效率。

Objective：To analyze the implementation situation and primary effect of pregnancy risk precaution and assessment management system in Shanghai,find out the problems and put forward suggestions for improvement.Methods：Pregnancy risk precaution and assessment screening scale,pregnancy risk precaution and assessment classification table and classification management scheme were formulated after literatures query and expert argumentation;related individual cases,report forms and spot field investigation data were collected at half a year after implementation of pregnancy risk precaution and assessment management system.Results：After usage of pregnancy risk precaution and assessment screening scale from January to June in 2010,17 069 positive pregnant women were found,the positive rate of primary screening was 22.3%;after usage of pregnancy risk precaution and assessment classification table,10 382 cases were found with diseases definitely,the diagnostic rate was 65%,the proportion of high risk pregnant women（red,orange and purple） was 6.6%,17 pregnant women who were not suitable for pregnancy were found,timely induction of labor and cesarean section were carried out to terminate pregnancy,thus,probable maternal death was avoided.Conclusion：Pregnancy risk precaution and assessment management system gets primary effect after implementation,especially,maternal mortality is controlled effectively;but the scheme needs to be specified further,construction of information platform should be promoted to improve efficiency of management.