孕产妇猝死28例相关因素分析

Analysis of factors related to 28 cases of maternal sudden death

目的 通过对 2 8例孕产妇猝死资料进行分析 ,归纳总结孕产妇猝死相关因素 ,为降低孕产妇猝死提出干预措施。方法 根据 1992～ 2 0 0 1年北京市朝阳区各级医院上报的区妇保所死亡病例和专家评审的资料回顾性统计分析。结果 孕产妇猝死占该组孕产妇死亡的 3 / 4,孕产妇猝死时间分布于妊娠期、分娩期、产褥期。猝死终末地点集中在二、三级医院。猝死原因依次为 :产科出血、羊水栓塞、妊娠合并心脏病、妊高征。死亡评审结论中可以避免和创造条件可以避免原因集中在提高医疗保健机构和个人家庭知识技能这一环节。与死因相关的高危因素包括医源性因素、疾病因素、社会人文因素。猝死孕产妇流行病学特征是流动人口、农村人口、低文化程度、计划外妊娠多见 ,并忽视围产期保健。结论 孕产妇猝死具有独立的临床特征 ,加强高危孕产妇监护、管理 ,提高急救医学和产科危重症抢救能力 ,抓住抢救时机 。

ObjectiveTo summarize the related factors of maternal sudden death by analysing the data of 28 cases,and find the way to decrease the maternal mortality rate.MethodsRetrospective analysis was done according to the death cases reported by hospita ls and the evaluation by specialists.ResultsThe rate of the maternal sudden death to the total death in this group was 3/4.The maternal sudden death occured antepartumly,intrapartumly and postpartumly,ma inly occurring in hospitals of class one and class two.The reasons of maternal s u dden death were:obstetric hemorrhage,amniotic fluid embolism,heart disease durin g pregnancy and pregnancy-induced hypertension syndrome,respectively.The relate d high-risk factors of sudden death included iatrogenic factors,disease factors a nd social factors.The results of death evaluation could improve the skill of the medical care organization and the people's knowledge in this aspect.The epidemi c features of maternal sudden death were that it mainly existed in mobile popula ti on,suburb population,uneducated people,pregnancy out of the family planning poli cy,which were lack of prenatal care and without monitoring.ConclusionThe maternal sudden death has independent clinical characteristics.Strengthenin g the screening,monitorin g and caring of the high-risk pregnancy and improving the doctors' ability in fi rst-aid and severe obstetrical cases can decrease the maternal mortality rate.