对新疆喀什莎车县孕产妇死亡现状的分析

Analysis of current status of maternal mortality in Shache County in Xingjiang

目的对新疆喀什莎车县孕产妇死亡的主要影响因素进行分析。方法通过妇幼保健服务网络收集2007年10月1日到2012年9月30日发生在新疆喀什莎车县的孕产妇死亡个案;对该县从事孕产期医疗保健服务业务和管理人员进行定性访谈。结果 5年内该县孕产妇死亡共75例,死亡率从2008年的123.17/10万逐步下降到2012年的69.25/10万,下降幅度达43.78%。死亡孕产妇中98.67%是维吾尔族,92.00%文化程度为初中及以下,42.67%的死亡孕产妇在整个孕期未接受产前检查。孕产妇死亡原因前3位依次为产科出血(48.00%)、妊娠期高血压疾病(29.34%)和羊水栓塞(8.00%)。整体卫生人力资源的缺乏及产科技术水平相对落后,影响了孕产期医疗保健服务提供的有效性,而当地社会经济、地理交通、文化习俗等因素又进一步制约了孕产期保健服务的利用。结论 5年来该地区孕产妇死亡率显著下降,产科出血和妊娠期高血压疾病是孕产妇主要死亡原因,该地区的孕产期保健服务提供相对不足和服务利用率较低,影响了孕产妇死亡率的进一步下降。

Objective To identify the major factors related to maternal mortality in Shache County in Xingjiang .Methods Maternal mortality and basic information of women was obtained from the maternal and child health care network between October 1st, 2007 and September 30th, 2012 in Shache County in Xinjiang , and qualitative interview was conducted among service and management personnel . Results In these five years there were 75 cases of maternal mortality in the county .The maternal mortality rate （ MMR） in the poverty county declined by 43.78%from 123.17 per 100 000 live births in 2008 to 69.25 per 100 000 live births in 2012.Among the mortality cases, 98.67%were cases of Uygur nationality , 92.00%did not accept 9 years or more education which was compulsory in China , and 42.67%had not received any antenatal care .The top three causes of maternal death were obstetric hemorrhage （48.00%）, pregnancy-induced hypertension （29.34%） and amniotic fluid embolism （8.00%）.Lack of health human resources and backward of scientific and technologic levels affected the efficacy of medical care service at pregnant period , and some factors including social economy , geographic transportation and culture restricted the utilization of health service .Conclusion The MMR of the poverty county has significantly decreased in the past five years , and obstetric hemorrhage and pregnancy-induced hypertension are the major causes of maternal mortality .Relative insufficient health care and low utilization of service hinder the further decrease of MMR .