吉林省2004～2009年孕产妇死亡情况分析

目的:分析吉林省孕产妇死亡情况,了解孕产妇系统管理中存在的问题,为制订有效降低孕产妇死亡率的干预措施提供科学依据。方法:回顾性分析吉林省2004～2009年孕产妇死亡的病例资料及评审结果,采用WHO十二格表进行分析。结果:①活产数变化:5年来吉林省孕产妇活产分娩数量略有增加,但增长幅度不显著。②孕产妇死亡率:2004～2009年吉林省孕产妇死亡率呈持续平稳的下降态势,2009年达27.12/10万,低于全国水平。③城乡孕产妇死亡构成比:5年间死亡构成比农村高于城市,但农村孕产妇死亡构成比呈下降态势。④死亡孕产妇住院分娩率:住院分娩率逐年增高,并以县(区)医院及省(市)医院为主。⑤死亡孕产妇孕期保健率:孕期保健率逐年提高,高危孕产妇管理率均在93%以上。⑥死因构成比及顺位:前5位死因依次为:产科出血、妊娠期高血压疾病、妊娠合并心脏病、羊水栓塞、肺栓塞。⑦直接产科原因与间接产科原因所致死亡:2007～2009年直接产科原因导致的死亡为95例(53.98%),间接产科原因导致的死亡为74例(42.05%)。⑧WHO十二格表分类:2007～2009年吉林省死亡孕产妇以医疗保健机构的知识技能问题占主要原因(45.20%),其次为个人家庭的知识技能原因(19.86%)。结论:①2004～2009年吉林省孕产妇死亡率呈逐年下降的趋势。②专业培训和孕期保健是母婴健康的保障。③随着孕产妇死因构成比的变化及服务需求的提高,探索新的服务与管理模式保障母婴安康更加显得十分必要。

Analysis on maternal deaths in Jilin province from 2004 to 2009

Objective:To analyze maternal deaths in Jilin province,understand the existing problems in maternal system management,provide a scientific basis for making interventional measures to reduce maternal mortality effectively.Methods:The data and evaluation results of maternal deaths in Jilin province from 2004 to 2009 were analyzed retrospectively by WHO twelve form method.Results:The number of live births in Jilin province from 2004 to 2009 increased slightly,but the increasing range was not significant.The maternal mortality in Jilin province from 2004 to 2009 showed a continuous and smooth decreasing trend,the maternal mortality in 2009 was 27.12 per 100 000 live births,which was lower than national average.The proportion of maternal deaths in rural area of Jilin province from 2004 to 2009 was higher than that in urban area of Jilin province,but the proportion of maternal deaths in rural area of Jilin province showed a decreasing trend.The hospital delivery rate of maternal deaths in Jilin province from 2004 to 2009 increased year by year,especially in hospitals at county(district) level and province(city) level.The rates of health care during pregnant period of maternal death in Jilin province from 2004 to 2009 increased year by year,the system management rates of high risk pregnant women in Jilin province from 2004 to 2009 were more than 93%.The top five causes of maternal deaths were obstetrical hemorrhage,hypertensive disorder complicating pregnancy(HDCP),pregnancy complicated with heart disease,amniotic fluid embolism,and pulmonary embolism.From 2007 to 2009,the number of maternal deaths induced by direct obstetrical causes was 95(53.98%),and the number of maternal deaths induced by indirect obstetrical causes was 74(42.05%).The main reason of maternal deaths in Jilin province from 2007 to 2009 was knowledge and skills of medical staff in medical care and health institutions(45.20%),followed by individual family knowledge and skills(19.86%).Conclusion:The maternal mortality in Jilin province from 2004 to 2009 showed a decreasing trend year by year.Professional training and gestational health care are effective measures to ensure maternal and infantile health.It is necessary to explore new service and management mode with the change of proportion of maternal deaths and the increase of service demand.