长沙市2001-2010年孕产妇死亡分析

Analysis of Maternal Mortality in Changsha City from 2001 to 2010

目的分析长沙市2001-2010年孕产妇死亡情况,探讨孕产妇死亡率的变化趋势、主要原因和变化特征,为降低孕产妇死亡率,制定相关干预措施提供科学依据。方法采用回顾性调查方法收集长沙市10年间孕产妇死亡报告卡、死亡调查报告以及评审结果,进行系统整理和分析。结果 2001-2010年长沙市孕产妇平均死亡率为20.46/10万,呈下降趋势(P<0.01),农村下降趋势较城市明显。城市、农村孕产妇平均死亡率分别为9.52/10万与24.79/10万,城市显著低于农村(P<0.01)。孕产妇死亡率随着住院分娩率的升高而下降。孕产妇的主要死亡原因为产科出血、妊娠合并内外科疾病、妊娠期高血压疾病和羊水栓塞,第一位死因由产科出血变成妊娠合并内外科疾病。结论加强孕产期保健管理,健全妇幼保健三级网络,提高住院分娩率,加强高危妊娠管理,提高乡镇卫生院及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 study the data of maternal death in Changsha City from 2001 to 2010,to analyze the change tendency,main reasons and regularity of maternal mortality,and to provide a scientific basis for developing intervention measures. Methods The death reporting cards,death survey reports,and the evaluation results in Changsha City from 2001 to 2010 were collected and analyzed retrospectively. Results In ten years,the average maternal mortality in Changsha City was 20.46/100,000,the whole level was decreased（P0.01）,and the declined tendency of maternal mortality in rural areas was more obvious than that in urban areas.The average maternal mortalities of urban and rural areas were 9.52/100,000 and 24.79/100,000,respectively;the mortality of urban areas was significantly lower than that of rural areas（P0.01）.The maternal mortality was dropped with the rising of hospitalization rate.The main factors of maternal death were obstetric hemorrhage,pregnancy with internal and surgical diseases,hypertensive disorder complicating pregnancy,and amnionic fluid embolism.As the first factor affecting maternal death,obstetric hemorrhage had superseded pregnancy with internal and surgical diseases. Conclusions The effective countermeasures to reduce the maternal mortality are as follows： strengthening maternal care and management,perfecting the maternal and child health network,raising hospital delivery rate,enhancing the management of high-risk pregnancy,and improving the maternal-emergency ability of township and county health care centers.