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目的探讨永州市孕产妇死亡中因产科出血死亡孕产妇的死亡原因和相关因素,提出干预措施。方法对永州市辖区内2003年1月￣2005年12月29例产科出血死亡孕产妇的资料进行回顾性分析。结果产科出血为永州市孕产妇死亡的第一原因占44.29%;29例产科出血死亡孕产妇死因构成依次为:胎盘因素14例占48.28%(14/29),宫缩乏力10例占34.48%(10/29),子宫破裂3例占10.34%(3/29),软产道损伤2例占6.9%(2/29);29例产科出血死亡孕产妇全部居住在山区农村。影响农村产科出血的主要因素为:住院分娩率低;家庭接生现象极严重;绿色通道不畅、转诊不力;孕产妇接受保健不足;基层医院医疗水平偏低等。结论可通过加大农村妇幼卫生经费投入;施行大学生“村妇幼专干”计划;设立孕产妇抢救专车;提高住院分娩率;坚决取缔家庭接生;整顿母娶保健服务市场等措施减少产科出血造成的孕产妇死亡。
Objective To investigate the causes and related factors of maternal deaths caused by obstetric hemorrhage during the maternal death in Yongzhou and to propose intervention measures. Methods The data of 29 maternal deaths from obstetric hemorrhage from January 2003 to December 2005 in Yongzhou were retrospectively analyzed. Results The obstetric hemorrhage was the first cause of maternal death in Yongzhou, accounting for 44.29%. The causes of death of maternal death in 29 cases of obstetric hemorrhage were: 14 cases (48.28%) with placental factors (14/29), 10 cases (34.48% (10/29), three cases of uterine rupture accounted for 10.34% (3/29), and two cases of soft birth canal injury accounted for 6.9% (2/29). All 29 pregnant women died of obstetric hemorrhage were living in mountainous rural areas. The main factors affecting rural obstetric hemorrhage are: low rate of hospital delivery; severe gravidity of the family; poor access to the green channel, poor referral; insufficient maternal health care; and low level of medical care in the primary hospitals. Conclusions It is possible to reduce the cost of obstetric hemorrhage by increasing the funding for MCH and rural maternal and child health education in rural areas, implementing the “Village MCH Program” for university students, setting up maternity salvage vehicles, increasing the rate of hospital delivery, resolutely banning family births, Maternal death.