防患未然，关口前移，积极推进孕产妇危重症评审工作

Promoting clinical audit for severe maternal morbidity cases through early prevention

对孕产妇危重症病例进行多学科参与的临床评审是避免孕产妇死亡的必由之路。当前可采用相关筛查标准和附加指标。特别是结合专家意见，确定真正的危重症和临床诊疗过程有待改进的病例进行评审。不管采用哪种方法和流程，都应尽快开展评审工作。同时，通过开展相关临床研究，探索适用于不同级别医院的标准化评审流程，为今后各种指南更新和政府卫生保健政策的制定提供依据。

The implementation of multidisciplinary clinical audit for cases with severe maternal morbidity is an important way to reduce preventable maternal death. We encourage using screening indicators and additional clinical criteria, especially professional review, to identify real critical case which is potentially improved and then trigger clinical audit. Whatever methods and processes we will take, it is time to start. Further investigations are needed to develop standardized process for facility-based clinical audit, and to provide evidence for u!adates of guidelines and public health policies.