昆明市贫困县1996年—2000年孕产妇死亡监测情况分析

目的：掌握昆明市贫困县1996－2000年孕产妇死亡变化趋势及相关因素，制定行之有效的干预措施，降低昆明地区孕产妇死亡率。方法：采用回顾性调查的方法，对5年来昆明市贫困县117例孕产妇死亡个案进行分析。结果：贫困县孕产妇死亡率平均占昆明市孕产妇死亡率的57．14％－72．73％；贫困县孕产妇死亡率1996年以来呈逐年下降趋势，由1996年的134．73／10万下降至2000年的83．67／10万，下降了40．12％，但与全国平均水平相比仍有较大差距；贫困县孕产妇前5位死因依次为：产科出血（77．78％），妊高征和心脏（4．27％），产褥感染（2．56％），羊水栓塞（1．71％），肝炎（0．85％）。产科出血中又以胎盘滞留占第一位，为53．33％，第二位为前置胎盘（17．78％），第三位为宫缩乏力（15．56％），第四位为凝血功能障碍及软产道损伤（6．67％），第五位为胎盘早剥（4．44％）。117例死亡孕产妇中，有104例居住山区，占88．89％，有100例为小学和文盲，占85．48％，死于产妇家中62例，占52．99％，死于途中19例，占16．23％。结论：贫困县孕产妇死亡率直接关系到昆明地区孕产妇死亡率。因此，分析，掌握该地区孕产妇死亡各种相关因素，积极推广各种适宜贫困县的措施，才可保证昆明市孕产妇死亡率有效下降，达到中国妇女发展纲要中提出的指标要求。

Analysis and Countermeasure of the Maternal Motality Detection from 1996 to 2000 in Poverty Region of Kunming City

Objective To understand the changing tendency of maternal mortality and relating factors from 1996 to 2000 in poverty region of Kunming City, in order to take effectively intervening measure to decrease the maternal mortality rate (MMR) in Kunming. Methods A retrospective analysis was made on the 117 cases of maternal mortality within 5 years in poverty region of Kunming City. Results The MMR in poverty region accounting for 57.14% 72.73% of MMR in Kunming is much higher than average level in China, but there is a decreasing tendency from 134.73 per 100,000 in 1996 to 83.67 per 100,000 in 2000. The causes of maternal death in succession were obstetric hemorrhage (77.78%), amniotic fluid embolism(6. 84%), pregnancy induced hypertension(4.27%), puerperal infection (2.56%), and hepatic diseases (0.85%). The five main causes of obstetric hemorrhage were retention of the placenta(53.33%), placenta previa (17.78%), complication of pregnancy(15.56%),injuries of the soft birth canal (6.67%),placental abruption (4.44%). Among the 117 pregnant women were 104 who lived in mountain area, accounting for 88.89% and 100 who only received primary education, accounting for 85.48%. There were 62 pregnant women accounting for 52.99% who died in the home and 19 on the way to hospital, accounting for 16.23%. Conclusion The MMR of poverty region has directly relation to the MMR of Kunming. We must analyse and master all kinds of factors related to maternal mortality, and generalize measures suitable for poverty region, so as to decrease the MMR and accomplice the tasks required by Developing program for Women.