孕产妇死亡原因分析

Analysis of Causes of Maternal Death

目的探讨重庆市垫江县2003-2012年孕产妇死亡原因。方法选取2003年1月至2012年12月垫江县74 532例孕产妇中,45例死亡孕产妇的临床病历资料为研究对象,回顾性分析孕产妇死亡率、死亡原因、死亡相关因素及专家评审结果(本研究遵循的程序符合重庆市垫江县妇幼保健院制定的伦理学标准,得到该委员会批准)。结果 2003-2012年全县孕产妇年平均死亡率为60.37/10万,2010-2012年为0/10万。前5年(2003-2007年)年平均死亡率较后5年(2008-2012年)年平均死亡率高,且差异有统计学意义(χ2=20.01,P<0.05)。孕产妇主要死亡原因顺位为产科出血(55.56%)、羊水栓塞(13.33%)及妊娠期高血压疾病(13.33%);孕产妇死亡可能与文化层次低、产前保健意识差、经济困难、多胎多产及交通不方便等因素有关。经专家评审,可避免和创造条件可避免死亡共39例(86.67%)。结论 2003-2012年,垫江县采取一系列干预措施保障母婴安全,使全县保持2010-2012年孕产妇死亡率为0。

Objective To analyze the causes of maternal death from 2003 to 2012 in Dianjiang County,Chongqing.Methods All maternal datas（74 532 cases） were collected from January 2003 to December 2012 in Dianjiang County,including 45 cases of death.A retrospective analysis had been done,which included maternal mortality rate,cause of death,death related factors and expert assessment results.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Maternal and Child Health Hospital of Dianjiang County,Chongqing.Results Maternal annual average mortality rate from 2003 to 2012 in whole county was 60.37/105,and 0/105 from 2010 to 2012.The annual average mortality rate of the first five years（2003-2007） was higher than that of the last five years（2008-2012）,and the difference was statistically significant （χ^2 =20.01,P 〈 0.05）.Main causes of death were obstetric hemorrhage （55.56%）,amniotic fluid embolism （13.33%） and hypertensive disorders of pregnancy （13.33%）,in turn.Maternal death may mainly be related to the low cultural level,poor health care awareness,economic difficulties,multiple births and inconvenient traffic,etc..Assessed by experts,there were 39 cases（86.67%） of death can be avoided by creating certain conditions.Conclusions From 2003 to 2012,a series of interference measures had been taken by Dianjiang County municipal to ensure mother and baby＇s safety,which made whole county kept zero maternal mortality rate from 2010 to 2012.