武汉市洪山区1986-2014年孕产妇死亡分析

Analysis of Maternal Mortality in Hongshan District of Wuhan in 1986-2014

目的探讨孕产妇死亡的原因及可能影响因素,为降低孕产妇死亡率提供有效的干预措施。方法采用回顾性动态分析方法,对1986-2014年29年间武汉市洪山区50例孕产妇死亡病例进行分析。结果 29年间洪山区孕产妇活产总数为137 854人,孕产妇平均死亡率为36.27/10万(其中流动孕产妇占54.00%)。孕产妇死因顺位是产科出血、羊水栓塞、异位妊娠、妊高征及妊娠合并心脏病(并列第4),可避免和创造条件可避免的死亡占81.40%,人均收入、户籍、文化素质、计划生育、孕期接受保健管理、产科质量等与孕产妇死亡有较直接的关系。结论必须认真做好围产期保健工作,降低以产科出血为主要死因的孕产妇死亡;重视流动人口及贫困孕产妇的管理工作,将流动孕产妇纳入基本公共卫生孕产妇健康管理项目中,设立贫困孕产妇救助基金。

Objectives To explore the causes of maternal death and possible affective factors,and to provide effec-tive intervention measures to reduce the maternal mortality.Methods Retros pective dynamic analysis method was used to analyze 50 cases of maternal death in Hongshan district from 1 986 to 2014.Results The number of live births during 29 years was 137854.The average maternal mortality was 36.27/ hundred thousand (flowing preg-nant women was accounted for 54.00%).The rank order of maternal mortality causes was obstetric hemorrhage, amniotic fluid embolism,ectopic pregnancy,pregnancy with hypertension syndrome and pregnancy complicated with heart disease (tied for fourth).The deaths which could be avoided were accounted for 81.4%.percapita in-come,household registration,cultural quality,family planning,prenatal health care management,obstetric quality and so on were directly associated with maternal death.Conclusions We must conscientiously do a good job in the health care in prenatal period,reduce maternal death of which the main cause is obstetric hemorrhage,think highly of the maternal management for the floating population and the poor.Flowing pregnant women should be included in the basic public health and maternal health management project,and the poor maternal rescue fund should be established.