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[目的]分析重庆市产科出血导致孕产妇死亡的原因及相关因素,提出干预措施,提高围产期保健质量,降低孕产妇死亡率。[方法]重庆市41个县(市)、区,按国家统一要求,填报孕产妇死亡报告卡,逐级上报重庆市妇幼保健院。分析2000～2008年产科出血致孕产妇死亡原因。[结果]重庆市因产科出血致孕产妇死亡的比例高于全国平均水平。2000～2008年重庆市死亡孕产妇共1654例。其中因产科出血死亡901例,占死亡总数的54.47%。产妇死亡与文化程度、地城分布及产前接受保健服务程度等因素有关。[结论]产科出血是孕产妇死亡的重要原因之一。居住农村、非住院分娩、文化程度低、经济困难、个人家庭保健意识缺乏及医疗保健系统的处理能力的不足是产科出血死亡的重要因素。加强健康教育,提高住院分娩率和接产人员对产后出血的防范意识,加强助产人员产科出血的急救知识技能的学习和培训是降低产科出血死亡干预的重点。
[Objective] To analyze the causes and related factors of maternal death caused by obstetric hemorrhage in Chongqing and put forward intervention measures to improve the quality of perinatal health care and reduce the maternal mortality rate. [Methods] 41 counties (cities) and districts in Chongqing municipality were required to fill in the report card of maternal death according to the unified national requirements and report them to Chongqing MCH center level by level. Analysis of causes of maternal death from obstetric hemorrhage from 2000 to 2008. [Results] The proportion of maternal deaths due to obstetric hemorrhage in Chongqing was higher than the national average. From 2000 to 2008, a total of 1654 pregnant women died in Chongqing. Among them, 901 died of obstetric hemorrhage, accounting for 54.47% of the total deaths. Maternal deaths were related to education, geo-city distribution and the level of prenatal health care services. [Conclusion] Obstetric hemorrhage is one of the important causes of maternal mortality. Living in rural areas, non-hospital delivery, low educational level, economic difficulties, lack of awareness of individual family health care and inadequate capacity of the health care system is an important factor in obstetric hemorrhage death. Strengthen health education, improve hospital delivery rate and the staff awareness of prevention of postpartum hemorrhage, and to enhance midwifery staff obstetric bleeding first aid knowledge and skills training is to reduce the death of obstetric hemorrhage intervention focus.