南宁市2008至2012年孕产妇死亡分析

摘要

Objective To grasp the main causes of death in pregnant women and its related factors by analyzing maternal deaths and the changing trend of death causes from 2008 to 2012 in Nanning, so as to put forward interventions to reduce maternal mortality. Methods Statistical analysis was conducted on the Survey Annual Report of Pregnant Women Health Care, Death Report Card from Resident Pregnant Women, survey on maternal death and assessment materials of maternal death in 6 counties and districts in Nanning from 2008 to 2012. Results There were 520 091 cases of live births and 149 cases of maternal mortality in Nanning, and the average mortality rate was 28. 64/100 000 (household mortality rate of 17. 49/100 000). The top five causes of maternal mortality were amniotic fluid embolism, pregnancy complicated with heart disease, pregnancy complicated with liver disease, pregnancy with cancer, and obstetric hemorrhage. Assessment results indicated 125 cases of inevitable death (71. 84%) and 49 cases of avoidable death (28. 16%). Monitoring data analysis showed that although the impact of maternal mortality was multifactorial, pregnancy complications proceeded in the rank of death causes. Among the top 5 causes, indirect obstetric death causes were more than direct obstetric ones. Conclusion The improvement of prenatal care tertiary care network management, early identification of medical complications of pregnancy by medical personnel, multidisciplinary joint monitoring management and the emergency treatment capability of obstetric team highlight their importance in rescuing critical cases and reducing maternal mortality rate.%目的：通过对南宁市2008至2012年孕产妇死亡监测情况和死因变化趋势分析，掌握孕产妇主要死因及其相关因素，有针对性的提出干预措施以降低孕产妇死亡率。方法对南宁市2008至2012年南宁市6县6城区孕产妇保健情况调查年报表、常住人口孕产妇死亡报告卡、孕产妇死亡调查表、孕产妇死亡评审资料进行统计分析。结果2008至2012年南宁市活产数520091例，孕产妇死亡149例，平均死亡率28.64/10万(其中户籍死亡17.49/10万)，孕产妇死亡原因前5位依次为：羊水栓塞、妊娠合并心脏病、妊娠合并肝病、妊娠合并恶性肿瘤、产后出血。评审结果显示不可避免死亡125例(71.84%)，可避免死亡49例(28.16%)。监测资料分析显示：虽然影响孕产妇死亡率是多因素的，但妊娠合并症在孕产妇死亡原因中排位上升，前5位死因中，间接产科死亡原因已超出直接产科原因。结论孕期三级保健网络管理的健全、医务人员对妊娠内科合并症的早期识别、高危孕产妇多学科联合监测管理、产科团队的应急救治反应能力对危重孕产妇的救治和降低孕产妇死亡率有重要作用。