北京市1995—2017年妊娠合并心脏病孕产妇死亡分析

Analysis of maternal death in pregnancycomplicated by heart disease in Beijing 1995-2017

目的分析北京市1995—2017年妊娠合并心脏病孕产妇死亡情况及死因,为降低孕产妇死亡率探索相应干预措施。方法按照国家孕产妇死亡监测方法,收集北京市1994年10月1日—2017年9月30日妊娠合并心脏病孕产妇死亡资料64例进行分析。结果1995—2017年北京市妊娠合并心脏病死亡率为1.9/10万,占孕产妇死亡总数的12.5%;死亡原因前三位分别为先天性心脏病(22例,占34.4%)、妊娠期高血压疾病性心脏病(14例,占21.9%)、围产期心肌病(7例,占10.9%);死亡影响因素前三位分别为医生知识技术水平欠缺(30例,占51.7%)、患者保健意识淡薄/依从性差(30例,占51.7%)、高危孕产妇管理不到位(22例,占37.9%)。结论加强妊娠合并心脏病的认识及相关知识技能培训;加强高危孕产妇管理,保障院内及院间转会诊通道畅通;同时加大宣传教育力度,增加社会支持力量是降低妊娠合并心脏病孕产妇死亡的重要措施。

Objective To analyze the maternal death in pregnancy complicated by heart disease in Beijing in 1995-2017,and to explore corresponding intervention measures to reduce maternal mortality.Methods According to the national maternal mortality monitoring method,64 maternal deaths of pregnant women with heart disease in Beijing from October 1,1994 to September 30,2017 were collected and analyzed.Results The mortality rate of pregnancy combined with heart disease in Beijing was 19/100000 in 1995-2017,accounting for 12.5%of the total maternal deaths.The top three causes of death were congenital heart disease(22 cases,34.4%),hypertensive heart disease during pregnancy(14 cases,21.9%),and perinatal cardiomyopathy(7 cases,10.9%).The top three risk factors for death were insufficient knowledge and skills of doctors(30 cases,51.7%),weak health care awareness/poor compliance of patients(30 cases,51.7%),and inadequate management of high-risk pregnant women(22 cases,37.9%).Conclusion It is important to strengthen the knowledge and skills training of pregnant women with heart disease,strengthen the management of high-risk pregnant women,ensure the smooth channel of referral in hospital and between hospitals,strengthen the propaganda and education,and increase the social support.