长沙市2018—2020年危重孕产妇监测及结果回顾

Surveillance and Results Review of Critically Ill Pregnant and Lying-in Women in Changsha from 2018 to 2020

目的回顾长沙市2018—2020年危重孕产妇的监测结果,了解危重孕产妇流行病学情况,以期提高危重孕产妇救治成功率,降低孕产妇病死率。方法采用回顾性调查分析的方法对长沙市2018—2020年危重孕产妇监测资料进行分析,以了解长沙市危重孕产妇的妊娠并发症或合并症发病情况及分布特点,为危重孕产妇干预措施的制定提供决策性依据。结果2018—2020年上报的个案中,20~34岁是生育主体,其次为≥35岁的高龄产妇;从文化程度来看,主要以大学或以上为主;2020年初产妇比例占50.12%,经产妇占49.88%;2020年有93.57%的孕产妇产检次数≥5次,略低于2019年的94.17%;2018—2020年剖宫产率分别为43.38%、41.80%、43.83%;2018—2020年危重孕产妇妊娠合并症/并发症发生率分别为784.13‰、834.40‰、783.80‰;宫缩乏力、软产道裂伤、前置胎盘为前3位产科出血原因;危重孕产妇发生率呈逐年下降趋势,死亡例数也逐年减少;凝血功能障碍是危重孕产妇系统功能障碍首位,其次为心血管功能障碍。结论重视危重孕产妇的管理,早识别、早干预妊娠并发症或合并症,有利于降低危重孕产妇发生率,降低孕产妇病死率,提高孕产妇救治率。

Objective To review the surveillance results of critically ill pregnant women in Changsha from 2018 to 2020,and to understand the epidemiological situation of critically ill pregnant and lying-in women,in order to improve the success rate of critically ill pregnant and lying-in women and reduce the mortality rate of pregnant and lying-in women.Methods A retrospective investigation and analysis method was used to analyze the surveillance data of critically ill pregnant women in Changsha from 2018 to 2020 to understand the incidence and distribution characteristics of pregnancy complications or comorbidities of critically ill pregnant women in Changsha,to formulate and provide a basis for decision-making.Results Among the cases reported from 2018 to 2020,20-34 years old was the main childbirth,followed by older women aged 35 years or older;from the perspective of education level,the majority are college or above;the proportion of women in early 2020 accounted for 50.12%.49.88%of postpartum women;93.57%of pregnant and parturients will have≥5 times of maternity check-ups in 2020,slightly lower than 94.17%in 2019;the cesarean section rates from 2018 to 2020 were 43.38%,41.80%,and 43.83%.The incidence of pregnancy complications/complications in critically ill pregnant women from 2018 to 2020 was 784.13‰,834.40‰,and 783.80‰respectively;uterine weakness,soft birth canal laceration,and placenta previa are the top three causes of obstetric hemorrhage;incidence of critically ill pregnant women showed a downward trend year by year,and the number of deaths also decreased year by year;coagulation dysfunction was the first of critically ill maternal system dysfunction,followed by cardiovascular dysfunction.Conclusion Emphasis on the management of critically ill pregnant women,early identification and early intervention of pregnancy complications or comorbidities,is beneficial to reduce the incidence of critically ill pregnant women,reduce the mortality rate of pregnant women,and increase the treatment rate of pregnant women.