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目的探讨高危妊娠的科学管理,以期降低孕产妇死亡。方法回顾分析2002年1月1日-2006年12月31日在我院产科门诊建卡以及行产科检查的孕妇7262例,按照卫生部妇幼卫生司《高危妊娠产前评分》标准进行随时筛选高危妊娠,并转入高危门诊。对孕妇做出相应的指导,提出保健及治疗方案,高危因素解除或分娩后进行高危结案。结果 7262例产妇中,共筛选出高危妊娠2475例,其中重度高危妊娠245例(9.90%),高危妊娠发生率逐年下降,重度高危妊娠发生率逐年上升,无孕产妇死亡。围产儿死亡率分别为1.18%、1.05%、0.96%、0.79%、0.61%。前5位高危因素分别是贫血,妊高症,胎位异常,糖尿病或糖耐量受损,肝炎或肝损害。重症高危妊娠因素前3位是子痫前期,肝炎或肝损害,糖尿病。结论对重症高危妊娠要给予高度重视,严格管理,重点追踪,加强追访联系,及时收住院等是管理中的重点,孕期的筛查、专案的管理、及时转诊、治疗、追访等环节不能脱节。对住院分娩者要选择适当的分娩途径,加强产程观察和重点监护,包括儿科医生进手术室、产房陪产,确保母婴安全。只有加强高危妊娠的科学管理,才能降低孕产妇死亡。
Objective To explore the scientific management of high-risk pregnancy in order to reduce maternal mortality. Methods Retrospective analysis of January 1, 2002 -2006 on December 31, 2006 obstetrics and gynecology in our hospital card building and obstetric examination of 7262 pregnant women, according to the Ministry of Health Maternal and Child Health Division “high-risk pregnancy prenatal score” criteria for screening at any time high risk Pregnancy, and transferred to high-risk clinics. Make corresponding guidance to pregnant women, put forward health care and treatment programs, high-risk factors to lift or post-delivery high-risk settlement. Results A total of 2475 high risk pregnancies were found in 7262 mothers, of which 245 (9.90%) were severe high risk pregnancies. The incidence of high risk pregnancies decreased year by year. The incidence of severe high risk pregnancies increased year by year without maternal mortality. Perinatal mortality rates were 1.18%, 1.05%, 0.96%, 0.79%, 0.61% respectively. The top 5 risk factors are anemia, pregnancy-induced hypertension, abnormal fetal position, impaired glucose tolerance or impaired glucose tolerance, hepatitis or liver damage. Severe high-risk pregnancy The first three factors are pre-eclampsia, hepatitis or liver damage, diabetes. CONCLUSIONS: High priority should be given to severe high-risk pregnancies. Strict management, key follow-up, intensified follow-up and prompt hospitalization are the key points in management, screening during pregnancy, project management, timely referral, treatment and follow-up Can not be out of touch. The hospital delivery to choose the appropriate delivery channels, to strengthen labor observation and intensive monitoring, including pediatricians into the operating room, delivery room paternity, to ensure the safety of mother and child. Only by strengthening the scientific management of high-risk pregnancies can we reduce maternal mortality.