2015-2020年杭州市危重孕产妇监测结果

Surveillance of maternal near miss in Hangzhou City from 2015 to 2020

目的了解2015—2020年杭州市危重孕产妇发生情况和危重症类型,为危重孕产妇的早期识别和干预提供参考。方法通过国家危重孕产妇监测网络直报系统收集2015—2020年杭州市5家医院的危重孕产妇资料,描述性分析危重孕产妇发生率、死亡率、妊娠合并症/并发症和危重症类型。结果2015—2020年杭州市5家监测医院收治住院孕产妇230490人,活产数182514人,患妊娠合并症/并发症177428例,危重孕产妇1790例,年均发生率为0.98%;其中2019年危重孕产妇发生率较高,为1.18%。院内孕产妇死亡率为3.29/10万,死亡指数为0.33%,2018—2020年无孕产妇死亡。危重孕产妇主要妊娠合并症/并发症为贫血、产科出血性疾病和妊娠高血压,发生率分别为79.33%、69.83%和16.65%。孕产妇危重症主要为凝血功能障碍、心血管功能障碍和呼吸功能障碍,发生率分别为87.23/万、20.44/万和9.70/万。结论2015—2020年杭州市危重孕产妇发生率较高,孕产妇院内死亡率有所下降;孕产妇危重症主要为凝血功能障碍,需加强对贫血和出血性疾病的防治。

Objective To investigate the prevalence and types of maternal near miss in Hangzhou City from 2015 to 2020,so as to provide insights into early identification and interventions for maternal near miss.Methods The data of maternal near miss in 5 hospitals of Hangzhou City from 2015 to 2020 were collected from China's National Maternal Near Miss Obstetrics Surveillance System,and the incidence and mortality of maternal near miss,types of pregnancy-re⁃lated complications/comorbidities and types of critical illness were descriptively analyzed.Results Totally 230490 preg⁃nant and lying-in women were recruited in 5 hospitals in Hangzhou City from 2015 to 2020,and there were 182514 live births,177428 women with pregnancy-related complications/comorbidities,and 1790 cases of maternal near miss with a 0.98%annual incidence rate.The incidence of maternal near miss was high in 2019(1.18%).The hospital mor⁃tality and death index were respectively 3.29/105 and 0.33%among pregnant and lying-in women from 2015 to 2020,and there was no death found among pregnant and lying-in women from 2018 to 2020.The main pregnancy-related complications/comorbidities included anemia(79.33%),obstetric hemorrhagic disorders(69.83%),and gestational hyperten⁃sion(16.65%).The main critical illness among maternal near miss included coagulation dysfunction(87.23/104),cardio⁃vascular dysfunction(20.44/104),and respiratory dysfunction(9.70/104).Conclusions The incidence of maternal near miss was high and the hospital mortality appeared a reduction tendency among pregnant and lying-in women in Hang⁃zhou City from 2015 to 2020.Coagulation dysfunction is the primary critical illness among maternal near miss,and the management of anemia and hemorrhagic diseases requires to be improved.