对加强农村围产期保健和适当剖宫产降低围产儿死亡率的评价

重视孕期的监护加强产程的观察 ,预防和减少难产、滞产、胎儿窘迫、产伤等是降低围产期死亡率 ,提高产科工作质量 ,提高人口素质的重要措施。一、资料和方法1.资料 :本辖区内 1990年至 1999年分娩总数为 5 0 17例 ,参加围产期保健数、剖宫产数等资料见表 1。10年间参加围产保健     

围产病理学在判断围产儿死亡原因中的重要性

围产病理学在判断围产儿死亡原因中的重要性刘伯宁围产病理学是研究围产期中胎儿、新生儿、胎盘及其附属物、母体器官特别是子宫胎盘床血管的生理性和病理性变化的一门学科。围产病理学在提高围产儿质量、降低围产儿死亡率中有十分重要的意义，它能将某些病理所见与胎儿或...     

降低双胎妊娠围产儿病死率的临床研究

本文通过我院104例双胎妊娠的临床资料,以1989年至1992年采取综合处理措施的55例双胎妊娠为研究组,1986年至1988年未采取综合处理措施的49例为对照组。结果表明,研究组剖宫产率为52.73％(对照组为32.65％),阴道分娩率为47.27％(对照组为67.35％);新生儿死亡研究组为4个,对照组新生儿死亡10个,P<0.05.说明双胎妊娠可适当放宽剖宫产指征,采取综合处理措施可降低围产儿病死率。     

围产保健与母亲安全

母亲安全 ,儿童优先是围产医学永恒的主题。该主题的初期目标是降低孕产妇和围产儿死亡率 ,中期目标是降低母婴发病率和残疾率 ,终期目标是提高人口素质。保障母亲安全是社会的责任 ,是妇女基本人权的体现。妊娠分娩是女性生殖健康的重要一环 ,关系到母子生命安全 ,是女性生殖健康中惟一涉及到一个以上个体的阶段。妊娠分娩虽然是正常的生理过程 ,但每个母亲和婴儿的健康与生命在这个过程中都面临着危险 ,母亲安全就是帮助母亲 ,克服和战胜这些危险 ,安全幸福地将一个新生命带到我们这个世界。“妊娠人生大事 ,务使母婴平安”是 1998年为纪…     

胎儿生物物理相评分预测高危妊娠围产儿预后的价值

为提高产科质量和产前监测水平,我们采用胎儿无负荷试验（ＮＳＴ）Ｂ超生物物理相（ＢＰＳ）综合评分预测高危妊娠围产儿预后,现报告如下。１资料与方法１． １临床资料 １９９８年８月至 ２０００年 ８月在我院检查并分娩的高危孕妇２０８例,２２－３８岁,产前行ＮＳＴ和Ｂ超ＢＰＳ评分测定,孕３５－４４周,其中４１周（不足４２周）７４例,４２周２１例,胎膜早破３６例,羊水过少２０例,妊高征２４例,,妊娠合并贫血１０例,ＩＵＧＲ、前置胎盘各４例,臀位６例,合并乙肝、早产、脐绕颈３周各３例。１．２检测方法１．２．１Ｎ…     

妊娠合并哮喘与围产儿预后

目的 探讨妊娠合并哮喘及其病情控制程度与围产儿预后的关系。方法 对1990年1月至1999年12月间我院住院分娩的妊娠合并哮喘患者16例的临床资料进行回顾性分析。按病情控制程度分为发作组(9例)及缓解组(7例),并随机选取同期住院分娩的孕妇32例作为对照组,对3组新生儿出生体重、出生1分钟Apgar评分、羊水状况、早产及胎儿宫内发育迟缓(IUGR)等围产儿预后指标进行比较分析。结果 发作组新生儿出生体重低于缓解组及对照组(P<0.05),后两组差异无显著性(P>0.05);发作组剖宫产分娩、新生儿Ⅰ度窒息、IUGR及羊水异常的发生比例高于对照组(P<0.05);发作组早产的发生比例与后两组相比,差异无显著性(P>0.05);结论 妊娠合并哮喘时,病情反复控制不良者可导致多种围产儿并发症,需积极治疗减轻病情.改善围产儿预后。     

126例双胎妊娠产科处理及围产儿死亡原因分析

１２６例双胎妊娠产科处理及围产儿死亡原因分析赵文卿刘继华张治秀（日照市人民医院）双胎妊娠为高危妊娠，孕产妇的并发症明显高于单胎妊娠，早产发生率及围产儿死亡率亦较高。因此，做好双胎妊娠的分娩期处理，降低围产儿死亡率是产科的重要课题。现将我院近４年来１２...     

275例围产儿死亡原因分析

围产儿死亡率是评价一个国家和地区社会经济发展及卫生状况的重要指标之一,也是衡量围产保健水平的主要指标。为了解和掌握北京市海淀区妇幼保健院围产儿的死亡情况及影响围产儿死亡的相关因素,从而明确围产儿保健的重点并制订相应的干预措施,降低围产儿死亡率。     

双胎妊娠产科处理与围产儿分析

双胎妊娠是高危妊娠疾病中高危因素较多的一种异常妊娠。低体重儿发生率和围产儿病死率明显高于单胎妊娠。现对1993年1月～1998年12月在我院分娩的246例双胎妊娠结局总结如下。一、资料分析我院在1993～1998年,6年期间住院分娩20632例,双胎妊娠246例,占1．2％（1：83）。孕妇年龄对～40岁,平均28．5岁;初产妇220例,经产妇26例;孕周28 4～40＋4周,平均孕36＋4周。1．主要并发症：（1）妊娠期并发症：早产133例占54．1％;中重度妊高征102例占41．5％;妊娠贫血76例占30．9％;胎盘早剥13例占5．3％;前置胎盘5例占2％。（2）分娩期并…     

An Investigation of the Maternal Antecedents of Perinatal Mortality in 2 Large Teaching Hospitals

Perinatal mortality reviews are a form of quality assurance, and the classification of perinatal mortality would be most useful if it assisted in strategies for prevention. Whilst the value of clinicopathological (autopsy) and separate neonatal classifications is recognized, the Whitfield classification, modified for Australian conditions and applied to 393 cases, clearly identified the major obstetric problems leading to perinatal death, and may therefore contribute to continuing improvement in prenatal care.     

Perinatal Mortality in Bahrain

A review of 583 perinatal deaths at the Ministry of Health hospitals in Bahrain, during the years 1985-1987 revealed a perinatal mortality rate of 19.6 per 1,000 total births. Lethal congenital malformations accounted for 145 (24.9%) deaths. Of the 438 normally formed infants there were 42.2% antepartum, 115 (26.3%) intrapartum and 138 (31.5%) early neonatal deaths; in 82.7% of cases the death was considered to be unavoidable. The population of Bahrain for 1986 according to the Central Statistics Organization (1) was 435,065, the majority of which was served by the Ministry of Health Maternity Service with approximately 10,000 deliveries per annum. The Ministry of Health provides maternity services through one main maternity hospital and 2 peripheral hospitals with consultant obstetric care. In addition to these, there are 3 maternity units run by midwives. High risk cases are usually delivered in the main hospital as there is a neonatal intensive care unit attached to it. The latter also acts as a referral centre for all sick babies in Bahrain. An analysis of the causes of perinatal deaths is an effective way of assessing the efficiency of maternity services. The objective of this study was to identify and improve the various factors influencing perinatal mortality in Bahrain.     

Under Reporting of Perinatal Mortality

A detailed analysis of perinatal deaths in 5 maternity hospitals in the Hunter Valley of N.S.W. was performed over a 2-year period to ascertain whether all such deaths were officially certified. There were 138 perinatal deaths identified, but of these, only 131 were registered with a medical certificate. The 7 cases not certified were all just past the borderline of the official N.S.W. definition, where a late abortion is distinguished from a stillbirth. This suggests that there is a small but significant degree of underreporting of such cases, which in turn marginally reduces the official N.S.W. perinatal mortality rate.     

Wessex Perinatal Mortality Survey 1982

Summary. A survey of 335 perinatal deaths in the Wessex region revealed a perinatal mortality rate of 10·1 per 1000 total births. Lethal malformations accounted for 82 (24%) deaths. Of the 253 normally formed infants, 124 (49%) died during pregnancy and 33 (13%) in labour. More than 60% of the stillbirths weighed >1500 g. Of the 96 postpartum deaths, half occurred within 24 h of delivery, mostly following complications of labour and circumstances suggesting hypoxia. The Aberdeen classification showed half of the mothers had pregnancy complications: other predisposing factors were identified in 10% of perinatal deaths. There were 185 neonatal deaths of which 150 occurred within 7 days and 35 within the next 3 weeks. Sixteen (46%) of the late neonatal deaths were due to a congenital abnormality; pregnancy or labour complications were present in six (32%) of the remaining 19 normally formed infants. Review of existing methods of antenatal supervision in particular, followed by the use of better monitoring systems for earlier detection of fetal distress and prompt action when indicated, together with improvement in neonatal care in the first 24 h after birth should further reduce the perinatal mortality.     

Twin Pregnancy: Prematurity and Perinatal Mortality

An 8-year (1976-1984) retrospective analysis was undertaken of the management and outcome of 245 twin pregnancies delivered at Flinders Medical Centre, Adelaide. The incidence of twin delivery was 1 in 69 with a perinatal mortality of 85.7 per 1,000 total births. Amongst 42 perinatal deaths, 28 were associated with preterm labour at or before 28 weeks' gestation. If bed rest in hospital is to be implemented as a possible means of improving perinatal outcome in twin pregnancy it needs to be effected between 21 and 28 weeks' gestation; there is no rational theoretical basis for hospitalization beyond this time.     

Maternal Mortality in Utah

Objective: To determine trends in maternal deaths in Utah, identify opportunities for preventive intervention, and analyze the mechanism of reporting maternal deaths.Methods: A retrospective review was performed of maternal death certificates and medical records in Utah from January 1, 1982, through December 31, 1994.Results: Sixty-two maternal deaths were identified. The risk of maternal death increased with maternal age and parity. The classic triad of hemorrhage (n = 8), infection (n = 5), and preeclampsia-eclampsia (n = 3) remains an important contributor (16 of 62 or 25.8%). However, trauma (n = 10), pulmonary embolism (n = 10), and maternal cardiac disease (n = 9) now account for 46.8% (29 of 62) of maternal deaths. A greater number of direct obstetric causes of maternal death (n = 20) were deemed preventable than indirect obstetric causes (n = 1) or nonobstetric causes (n = 4).Conclusion: Trauma, pulmonary embolism, and maternal cardiac disease have emerged as the most common identifiable causes of maternal death. Improvements in prevention, earlier diagnosis, and aggressive treatment of these conditions are necessary to achieve the Public Health Service year 2000 objective of a 50% reduction in maternal mortality ratios (using the 1987 ratio as a baseline).