芜湖市2005至2014年孕产妇死亡监测分析及干预探讨

目的通过分析芜湖市近10年中孕产妇死亡情况,找出死亡原因及变化趋势,探讨进一步的工作思路。方法对芜湖市9个县区2005至2014年孕产妇死亡监测报表、报告卡、调查附卷和评审资料进行分析。结果 2005至2014年芜湖市孕产妇共死亡35例,前5年(2005至2009年)平均死亡率(22.76/10万)较后5年(2010至2014年)平均死亡率(9.64/10万)高,且差异有统计学意义(x^2=6.59,P<0.05)。死因构成比前5年产科出血为首(42.86%),后5年妊娠合并心脏病为首(28.57%)。评审结果可避免死亡33例(94.29%),不可避免死亡2例(5.71%),差异有统计学意义(x^2=27.46,P<0.05)。结论芜湖市近10年孕产妇死亡率呈下降趋势,农村下降更为明显;产科质量逐年提高,首位死因从产科出血转为妊娠合并心脏病;加强对危重孕产妇医院监测是进一步降低孕产妇死亡率的重要措施。

Monitoring of maternal death during 2005-2014 in Wuhu and intervention discussion

Objective To investigate the death causes and their change trend so as to discuss further working thoughts by comprehensive monitoring of maternal death in Wuhu City in last 10 years.Methods Analysis was conducted on monitoring reports, report card, survey appendix and review data of maternal death of 9 counties from 2005 to 2014 in Wuhu City.Results From 2005 to 2014 in Wuhu City a total of 35 maternal cases died.The average mortality rate (22.76/100000) of first 5 years (2005 -2009) was higher than that (9.64/100000) of later five years (2010 -2014), and there was statistical significance (χ2 =6.59,P <0.05).Obstetric hemorrhage (42.86%) ranked first among the causes of death in first 5 years, and pregnancy with heart disease (28.57%) ranked first in late 5 years.Review results showed that 33 cases (94.29%) could be avoided and 2 cases (5.71%) were inevitable with statistical significance (χ2 =27.46,P<0.05).Conclusion The mortality of pregnant and delivery women in Wuhu City shows a decreasing trend in recent 10 years;and decrease in rural area is more obvious.Obstetrics quality improves year by year; and the first cause of death transfers to pregnancy with cardiac disease from obstetric hemorrhage.Strengthening the monitoring work of critically sick pregnant women in hospital is the important measure to further reduce maternal mortality.