危重孕产妇管理与孕产妇死亡防控

孕产妇死亡率(MMR)是衡量一个国家或地区妇女健康状况和社会经济发展的重要指标之一。随着社会经济的发展与孕产妇健康水平的提高，孕产妇死亡已成为极低概率事件，尤其是在发达国家，仅仅使用孕产妇死亡及MMR作为终末指标，已无法全面评价和反映孕产妇医疗保健过程的质量和妇幼健康事业的发展现状，难以为改善孕产妇医疗保健政策及策略的制订，提供有效参考信息。对于将危重孕产妇的临床管理作为导致孕产妇死亡的动态过程和前期指标，这对强化危重孕产妇管理，进而降低MMR，具有重要临床意义。笔者拟就全球近年危重孕产妇管理、救治现状及其最新研究进展进行阐述，旨在为促进我国危重孕产妇应急管理及救治体系的建设和完善提供参考，从而有效提高危重孕产妇急救效率和质量，切实降低MMR。

Maternal near miss management and maternal mortality prevention

Maternal mortality ratio (MMR) is one of the important indicators for assessing the health status of pregnant women and socioeconomic development. With the development of economy and health status of pregnant women, MMR has continuously decreased especially in developed countries where maternal death is rare. Only using the available information from maternal death or MMR can no longer comprehensively evaluate the quality of maternal health care and the development of women′s health care. Additionally, it is difficult to provide adequate and effective information to improve maternal health policies because of a small number of maternal deaths. Maternal near miss management as an early indicator to describe the dynamic process of maternal death, has great significance for strengthening the dynamic management of maternal deaths and reducing MMR. In order to strengthen the emergency management system of maternal near miss, we review the global management and rescue status of maternal near miss and sum up the experience, to effectively improve the efficiency and quality of maternal rescue, and to reduce the MMR.