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目的:分析海南省孕产妇死亡率的变化趋势、死亡原因、构成特点及影响因素,提出进一步降低孕产妇死亡率的干预措施,为制定卫生管理策略提供依据。方法:回顾性分析海南省2001～2010年孕产妇死亡病例资料及评审结果。结果:10年间海南省死亡孕产妇315例,平均死亡率为34.66/10万,波动范围在24.74/10万～47.54/10万。2010年孕产妇死亡率为24.74/10万,较2000年的44.28/10万下降了44.13%,达到了《中国妇女发展纲要(2000～2010年)》的目标要求。产科出血、妊娠期高血压疾病、羊水栓塞仍是海南省孕产妇死亡的前3位原因。315例死亡孕产妇中有19.68%未做产前检查,仅22.22%在产前行5次及以上产前检查。315例死亡病例中可避免死亡242例,占76.83%;不可避免死亡73例,占23.17%。结论:落实妇女健康保障的政策,做好农村孕产妇住院分娩补助等重大公共卫生服务项目,开展广泛的妇幼卫生健康教育,加强妇幼卫生的能力建设,特别是县、乡、村妇幼卫生网络的建设,畅通危重孕产妇的转诊急救通道,加强管理,提高产科服务能力与服务质量,促进城乡、区域和人群间妇幼卫生工作协调发展是保障孕产妇生命安全的重要措施。
Objective: To analyze the changing trend of maternal mortality rate, cause of death, compositional characteristics and influential factors in Hainan Province, and to propose interventions to further reduce the maternal mortality rate and provide the basis for formulating health management strategies. Methods: The data of maternal deaths from 2001 to 2010 in Hainan Province and the review results were retrospectively analyzed. Results: In the 10 years, 315 pregnant women died in Hainan Province, with an average mortality rate of 34.66 / 100 000, fluctuating in the range of 24.74 / 100000 to 47.54 / 100000. The 2010 maternal mortality rate was 24.74 / 100,000, down 44.13% from 44.28 / 100000 in 2000, meeting the target requirements of the “Outline for the Development of Chinese Women (2000-2010).” Obstetric hemorrhage, hypertensive disorders during pregnancy, amniotic fluid embolism is still the leading cause of maternal death in Hainan Province. Among 315 cases of pregnant women who died, 19.68% did not make prenatal examination and only 22.22% did prenatal examination five times or more. Of the 315 deaths, 242 were avoidable deaths, accounting for 76.83%; 73 were inevitable deaths, accounting for 23.17%. Conclusion: The implementation of women’s health insurance policy, well-funded rural maternal hospital delivery and other major public health services, to carry out a wide range of health education for MCH and strengthen the capacity-building of MCH, especially the county, township and village MCH networks It is an important measure to ensure the safety of maternal life by establishing and smoothing the referral first aid channel that endangers maternal health, strengthening management, improving obstetric service ability and service quality, and promoting the coordinated development of maternal and child health work between urban and rural areas, regions and populations.