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目的分析郑州市2004-2011年产科出血导致的孕产妇死亡,提出干预措施,以降低孕产妇死亡率。方法回顾性分析2004-2011年郑州市产科出血孕产妇死亡资料。结果 68例产科出血导致的孕产妇死亡占全部孕产妇死亡的32.08%,农村孕产妇占35.76%;在县乡级医院分娩者占75.0%,非住院分娩占17.65%;导致产科出血的因素中宫缩乏力占61.77%,居首位,其次为子宫破裂、软产道裂伤及胎盘因素,各占11.76%;无指征滥用催产药物及经产妇产科出血死亡者居多。结论居住农村、基层医院产科处理能力不足、经产妇及非住院分娩是产科出血死亡的重要因素。加强基层产科建设及业务培训,提高产科质量,积极处理第三产程,适时转诊,多科室合作,构建产科危重症的救治中心,可有效降低产科出血所致的孕产妇死亡率。
Objective To analyze maternal deaths caused by obstetric hemorrhage in Zhengzhou from 2004 to 2011 and propose interventions to reduce the maternal mortality rate. Methods The data of maternal death in obstetric hemorrhage in Zhengzhou from 2004 to 2011 were retrospectively analyzed. Results 68 maternal deaths caused by obstetric hemorrhage accounted for 32.08% of all maternal deaths, 35.76% of pregnant women in rural areas, 75.0% of births in county-level hospitals and 17.65% of non-hospital births, among the factors causing obstetric hemorrhage Uterine inertia accounted for 61.77%, ranking first, followed by uterine rupture, soft birth canal laceration and placental factors, each accounted for 11.76%; no indications abuse of oxytocin drugs and obstetrics and gynecology bleeding were the majority of deaths. Conclusion In rural areas, primary hospitals lack of maternity capacity and maternal and non-hospital delivery are the major causes of obstetric hemorrhage. Strengthen the obstetric construction and business training at the grassroots level to improve the quality of obstetrics, and actively handle the third stage of labor, timely referral, multidisciplinary cooperation, and build obstetric critical care center can effectively reduce the maternal mortality rate caused by obstetric hemorrhage.