绵阳市2011-2017年孕产妇死亡影响因素分析及对策

Analysis and countermeasures of influencing factors of maternal mortality in Mianyang city from 2011 to 2017

目的分析绵阳市2011-2017年孕产妇死亡的影响因素,为全面二孩政策下采取有效的干预措施保障母婴安全。方法利用绵阳市2011-2017年孕产妇死亡病例、个案卡及死亡评审结果,回顾性地分析孕产妇死亡原因和影响因素。结果绵阳市2011-2017年孕产妇死亡40例,孕产妇死亡率从2011年19.7/10万降至2017年9.01/10万。孕产妇死亡原因前3位分别是产科出血、羊水栓塞、蛛网膜下腔出血。死亡孕产妇中高龄产妇占30%,65%的死亡孕产妇有多次妊娠史,57.5%的孕产妇户籍地在农村,可避免死亡率为70%。结论绵阳市孕产妇死亡率低于全省、全国平均水平,应提高保健覆盖率、医疗机构产科质量、健康教育宣传力度,重视流动孕产妇、高龄孕产妇、高危孕产妇,保障母婴安全。

Objective To analyze the influencing factors of maternal death in Mianyang City from 2011 to 2017 for adopting the effective intervention measures to ensure the safety of mother and child under the full executed two-child policy. Methods The causes and influencing factors of maternal death were retrospectively analyzed by utilizing the maternal death cases,case cards and death assessment results in Mianyang City during 2011-2017. Results There were 40 maternal death cases in Mianyang City during 2011-2017.The maternal mortality rate was dropped from 19.7/10 million in 2011 to 9.01/10 million in 2017.The top three causes of maternal death were obstetric hemorrhage,amniotic fluid embolism and subarachnoid hemorrhage.Among them,elderly parturient women accounted for 30%,65% of dead parturient women had multiple pregnancy history,and 57.5% parturient women came from countryside.The avoidable mortality rate was 70%. Conclusion The maternal mortality rate in Mianyang City is lower than the average of Sichuan Province and whole country.The health care coverage rate,the quality of obstetrics in the medical institutions and the health education publicity intensity should be increased,and pay attention to floating pregnant and lying-in women,elderly and high-risk pregnant women for ensuring the safety of mother and child.