论文部分内容阅读
目的分析孕产妇产科出血死亡原因及相关因素,提出切实可行的干预措施,提高围生期保健质量,降低孕产妇死亡率。方法通过全省三级妇幼保健网收集报表与病历摘要,将所有上报资料进行分类统计,分析2005-2014年河南省孕产妇死亡监测及评审资料中的929例产科出血资料。结果 10年死亡孕产妇共2 417例,其中产科出血死亡929例,占死亡总数的38.44%,产后出血占79.01%,宫缩乏力和胎盘滞留是产后出血死亡的主要原因。高龄、文化程度低、经济困难、计划外妊娠、孕产次数多、产检次数少、产科技术薄弱等是产科出血死亡的重要因素。结论 10年来产科出血死亡率呈逐年下降趋势,但仍居全省孕产妇死亡的首位原因,以产后出血为主。加大基层医疗卫生投入;加强宣传教育改变观念,提高保健意识,提倡进行系统、科学的围生期保健;重视生育政策的变化,贮备医疗资源等是降低产科出血死亡干预措施的重点。
Objective To analyze the causes and related factors of maternal obstetric hemorrhage death and put forward feasible interventions to improve the perinatal health care quality and reduce the maternal mortality rate. Methods Collect reports and medical record summary through three provincial level maternal and child health care networks, classify all the reported data, and analyze 929 obstetric bleeding data in 2005-2014 maternal death monitoring and assessment data in Henan Province. Results There were 2 417 maternal deaths in 10 years, of which 929 died of obstetric hemorrhage, accounting for 38.44% of all deaths, postpartum hemorrhage accounted for 79.01%. Uterine atony and placenta accreta were the main causes of postpartum hemorrhage. Elderly, low educational level, economic difficulties, unplanned pregnancy, pregnancy frequency, less number of births, obstetric technology is weak and so is an important factor in the death of obstetric hemorrhage. Conclusions The mortality rate of obstetric hemorrhage has been declining year by year in 10 years, but it is still the first cause of maternal death in the whole province with the majority of postpartum hemorrhage. Increase primary health care investment; strengthen publicity and education to change their concepts, raise awareness of health care, promote systematic and scientific perinatal health care; pay attention to changes in the birth policy and reserve medical resources are the focus of interventions to reduce death from obstetric hemorrhage.