2000-2013年度广州市花都区孕产妇死亡原因分析

Analysis of Maternal Death Causes in Huadu District,Guangzhou During 2000-2013

目的分析广州市花都区孕产妇死亡原因,了解孕产妇管理系统及救治过程中存在的问题,为制订降低孕产妇死亡率的干预措施提供科学依据。方法回顾性分析广州市花都区2000-2013年度孕产妇死亡病例资料及评审结果。结果在研究的14年中,广州市花都区活产数逐年增加,平均年增长率为10.58%。孕产妇死亡率在广州花都区户籍人口平均为21.73/105,在全人口平均为38.45/105,近14年孕产妇死亡共计65例,其死亡率逐年下降,尤其在流动人口中孕产妇死亡率降低明显。导致孕产妇死亡原因中,直接产科死因为64.62%,间接产科死因为30.77%,死因不明为4.62%。其中,居于前5位的孕产妇死因分别为羊水栓塞、产后出血、妊娠合并心脏病、妊娠期高血压疾病和异位妊娠。结论孕产妇死亡原因呈多元化趋势,死因构成比的变化为探索新的产科服务模式提出新的挑战。专业技能培训和孕产期系统保健是母婴安康的保障。

Objective To analyze the maternal death causes of the region and find out problems in maternal treatment process and management system in order to provide a scientific basis for the development of interventions to reduce maternal mortality. Methods Retrospectively analyze dates on annual maternal deaths information and assessment results in Huadu District, Guangzhou from 2000 to 2013. Results The number of live birth increased year by year in Huadu District, Guangzhou in 14 years. The total cases of maternal death is 65, and the average annual incremental rate is 10.58%. Maternal mortality of average household population and the whole population is 21.73/105 and 38.45/105 respectively. The maternal mortality rate decreased year by year in 14 years, especially the migrants maternal mortality rate reduced significantly. Direct obstetric causes of death is 64.62%,indirect obstetric causes of death is 30.77% and unknown causes of death is 4.62%. The top five causes of maternal death are amniotic fluid embolism, postpartum hemorrhage, pregnancy with heart disease, hypertensive disorders in pregnancy and ectopic pregnancy. Conclusions The causes of maternal death showed a trend of diversification, changes in the ratio of mortality presented new challenges for us to explore new obstetric service model. Professional skills training and maternal health system are the guarantee for maternal and child＇s well-being.