2019-2021年云南省昆明市某社区高危孕产妇管理状况分析

Management Status Analysis of High-Risk Pregnant and Postpartum Women in a Community of Kunming City,Yunnan Province from 2019 to 2021

目的通过对昆明市某社区2019—2021年高危孕产妇资料进行分析,了解孕产妇风险评估等级,并根据风险等级分析了年龄、孕次、产次、产前检查次数、分娩方式的情况,最后根据结局提出高危孕产妇管理改进意见。方法本次调查对象为2019—2021年在昆明市某社区卫生服务中心进行建档建册的所有孕产妇(共1159人),采用问卷调查和妇幼卫生工作台账以及《母婴保健手册》分析相结合的方式,汇总分析该社区近三年的孕产妇管理情况和高危孕产妇存在的风险。结果三年的孕产妇总数总体呈下降趋势,高危产妇筛出率在40%左右,高危孕妇转归情况无变化与好转或解除的比例大约是1∶1。孕产妇风险评估等级不同的,年龄、孕次、产次、产前检查次数、分娩方式也不同,存在统计学差异(P<0.05)。结论随着年龄、孕次、产次的增加,高危孕产妇人数的占比和风险评估等级越来越高。剖宫产的分娩方式以及适用指征还需要进一步审慎考虑。还需提高高危孕产妇的个体化管理程度,健全孕期检查次数的追踪核查机制,加强孕妇必要知识的培训,使其增强健康意识。

Objective To analyze data of high-risk pregnant and postpartum women in a community of Kunming from 2019 to 2021,understand their risk a ssessment level,and analyze situation of age,pregnancy,childbirth,prenatal examination frequency,delivery method based on the risk level,and proposed suggestions for management improvement based on the results finally.Methods Survey objects were all pregnant and postpartum women(1159 in total)registered in a community health service center in Kunming from 2019 to 2021.The paper summarize and analyze management situation of pregnant and postpartum women and risks of high-risk pregnant and postpartum women in the community during the past three years with combination of questionnaire survey,maternal and child health work ledger,and analysis of the Maternal and Child Health Handbook.Results Total number of pregnant women during the past three years showed overall downward trend,with a screening rate of around 40%for high-risk women.Proportion of no outcome change and improvement or relief of high-risk women was approximately 1:1.There was statistical difference in risk assessment level,age,gestational age,parity,number of prenatal examinations,and delivery method for pregnant and postpartum women,(P<0.05).Conclusion Proportion of high-risk pregnant women and level of risk assessment are higher and higher with increase of age,pregnancy frequency and parity.Delivery method and applicable indications for cesarean section need further careful consideration.It is necessary to improve level of individualized management for high-risk pregnant women,establish sound mechanism for tracking and verifying the number of prenatal examinations,and strengthen training on necessary knowledge for pregnant women to enhance their health awareness.