卫生Ⅷ项目地区77例孕产妇死亡地点与死因分析及“母婴安全”模型研究

目的:分析造成孕产妇死亡的主要原因及其关键环节,总结卫生Ⅷ项目相关干预经验,探讨进一步有效降低项目地区孕产妇死亡率的干预措施。方法:通过对典型个案的回顾性研究,总结分析孕产妇死亡原因、死亡地点等情况。结果:在死亡孕产妇中存在着“3个延迟”,49.35%没有及时作出就医决定,23.38%没能够及时到达医疗机构,有18.18%到达医院但没有得到及时的救治或救治条件有限抢救无效;产后出血为其主要死因(占66.23%),导致产后出血的主要原因为胎盘滞留(35.29%)、子宫破裂(17.65%)、副胎盘粘连(13.73%)、宫缩乏力(11.76%)等。结论:要采取多种措施促进住院分娩,加强高危筛查,建立高危孕产妇应急处理机制,加强乡卫生院产科建设。

Analysis of death address and death cause of 77 pregnant women in the health Ⅷ project areas and model research of maternal and child safety

Objective:To analyze the main causes and key taches of maternity death, and sum up the intervention experience, in order to explore health Ⅷ project intervention strategies to further decrease maternity death rate in project areas.Methods:The death cause and death address status etc were analyzed through reviewing of representative cases.Results:There existed three kinds of delay during the 77 dead pregnant women: 49.35% of them could not make decisions to hospitals in time, 23.38% of them could not reach the hospitals in time;18.18% of them had reached there in time, but they were not saved effectively in time. The main causes of maternity death were postpartum hemorrhage, accounting for 66.23%.The main causes of postpartum hemorrhage were placenta resort (35.29%), uterus breach (17.65%), placenta conglutination (13.73%) and uterine inertia (11.76%).Conclusion:It is necessary to take a lot of measures to promote hospital delivery, strengthen the filtration of pregnant women with high risks, establish emergency disposal mechanism aimed at pregnancy women with high risks and reinforce the construction of maternity department in the township health centers.