359例妊娠晚期胎死宫内原因分析

目的:探讨妊娠晚期突发胎死宫内原因,降低围生儿死亡率。方法:回顾性分析2006年1月～2011年9月该区行死胎引产的妊娠晚期突发胎死宫内359例患者资料,将围生儿死亡分为3种:①不可避免死亡;②创造条件可以避免死亡;③可以避免死亡。所有病例均参加了区级围生儿死亡评审,按上述对每例死亡的病因、处理过程进行全面的临床分析。结果:综合评定结果:不可避免死亡189例,创造条件可以避免死亡110例,可避免死亡60例。脐带因素造成的死因孕周≥35 W明显高于28～34+6W(P<0.05)。结论:发展和提高产前诊断和产前保健技术,加强对患者孕期知识的健康教育,加强Ⅰ级医院医务人员的基础理论知识的培训,加强高危妊娠的管理,积极防治妊娠并发症是降低围生儿死亡的重要措施。

Analysis on the causes of intrauterine death in 359 cases during the third trimester of pregnancy

Objective:To explore the causes of sudden intrauterine death during the third trimester of pregnancy,reduce perinatal mortality.Methods:The data of 359 patients with sudden intrauterine death during the third trimester of pregnancy caused by induced labor of stillbirth in Xinhui district from January 2006 to September 2011 were analyzed retrospectively;all the perinatal deaths were divided into unavoidable death,avoidable death if favorable conditions had been created,and avoidable death.All the cases participated in perinatal death review at district level;the cause of perinatal death and process of every case were analyzed comprehensively.Results:The results of comprehensive review: 189 cases were unavoidable,110 cases were avoidable if favorable conditions had been created,and 60 cases were avoidable.The proportion of perinatal death induced by umbilical cord factors at ≥35 gestational weeks was statistically significantly higher than that at 28-34+6 gestational weeks(P<0.05).Conclusion:The important measures to reduce perinatal mortality include developing and improving techniques of prenatal diagnosis and prenatal heath care,enhancing health education of gestational knowledge for the patients,strengthening basic theoretical knowledge training of medical staff in primary hospitals,enhancing management of high risk pregnancy,and preventing and curing pregnant complications actively.