上海市孕产期重点疾病筛查方法及初步效果

目的:评估妊娠风险预警评估的可行性和科学性。方法:回顾性分析上海市试点单位孕产期管理相关资料。结果:①38个试点社区重点孕妇初筛率22.11%,确诊率10.13%;在建册人群中重点孕妇的发生率为2.24%。不同户籍间重点孕妇筛出率、确诊率差异无统计学意义。重点疾病顺位前3位为妊娠合并心脏病、妊娠期高血压疾病、妊娠期糖尿病或妊娠合并糖尿病。②33家试点接产医院重点孕妇确诊率1.60%,重点疾病顺位前3位为妊娠合并心脏病、妊娠期高血压疾病、妊娠合并甲亢\甲减;2009年第2季度和2008年同期相比其危重孕产妇发生数、围产儿及孕产妇死亡数均有所下降。③2009年第2季度确诊6例不宜继续妊娠孕妇并成功终止妊娠。结论:妊娠风险预警评估方法与传统高危评分相比特异性高,可以在减少高危管理人数的同时,提高管理的针对性和有效性。

The preliminary effects of severe disease screening during pregnancy in Shanghai

Objective:To evaluate the feasibility and rationality of pregnancy risk precaution and assessment mechanism.Methods:Retrospective analysis of relevant pregnancy management information from pilot institutes in Shanghai.Results:①The screening rate of severe diseases during pregnancy in 38 pilot communities was 22.11%,the diagnostic rate was 10.13%;the incidence of severe diseases of the women who had registered during pregnancy was 2.24%.The screening and diagnosis rates had no significant differences between local and migrant pregnant women in Shanghai.The top three severe diseases during pregnancy were heart disease,hypertensive disorders complicating pregnancy,diabetes or gestational diabetes mellitus.②The diagnosis rate of severe diseases during pregnancy in 33 pilot hospital was 1.60%,the top three severe complications during pregnancy were heart disease,hypertensive disorders complicating pregnancy,hyperthyroidism hypothyroidism;the incidence of complications during pregnant,perinatal and maternal mortality had declined from 2008 to 2009 in the same period.③Six cases of pregnant women who were not capable of giving birth to babies were confirmed.Their pregnancies were terminated successfully by medical workers.Conclusion:Pregnancy risk precaution and assessment has higher specificity rate than the traditional high-risk score assessment.It can reduce the number of high risk pregnancy in management,and improve the relevance and effectiveness of management.