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目的:文章通过对余姚市梨洲镇近5年围产儿死亡情况及影响因素的调查分析,明确该乡镇围产儿死亡的主要原因,以便提出必要的干预措施,降低围产儿死亡率。方法:对2006-2010年在该院分娩的所有围产儿死亡病例进行回顾性分析,统计学方法采用χ2检验。结果:2006-2010年5年间该院分娩围产儿死亡率为12.33‰;流动人口与本地户籍的围产儿死亡构成比差异有显著性;死产病例全部为流动人口;死胎主要原因为胎儿畸形、脐带胎盘因素、母体疾病、胎膜早破,死产主要原因为家庭分娩、脐带脱垂、子宫破裂和早产,早期新生儿死亡主要原因为早产、新生儿窒息、出生缺陷、胎盘早剥等;死亡病例中分娩孕周小于37周的占55.89%,其中孕34周前分娩25例,占65.79%。结论:流动人口围产儿死亡是导致医院围产儿死亡率高于本地区围产儿死亡率的主要原因;胎儿畸形是死胎明确病因中的首位;早产是新生儿死亡的首位原因。需加强流动孕妇管理,加强宣传教育,把国家免费发放叶酸和分娩补助政策落到实处,加强分娩救助,提高流动孕妇的产前检查率和住院分娩率;规范产前检查,提高胎儿产前畸形筛出率及必要的产前诊断方法,及早预防和减少胎儿畸形的发生,及早诊断胎儿畸形;提高围产儿死亡的病理诊断水平以明确病因;产、儿科配合,提高新生儿窒息复苏水平。
OBJECTIVE: Through the investigation and analysis of the perinatal death and influencing factors in LiZhou Town, Yuyao City, this article makes clear the main causes of perinatal death in this township in order to put forward the necessary interventions and reduce the perinatal mortality rate. Methods: All perinatal deaths in this hospital from 2006 to 2010 were retrospectively analyzed. Chi-square test was used for statistical methods. Results: The perinatal mortality rate in this hospital was 12.33 ‰ between 2006 and 2010. The difference in perinatal mortality between floating population and local household registration was significant. All cases of stillbirth were floating population. The main causes of stillbirth were fetal malformation, Umbilical cord placenta factors, maternal diseases, premature rupture of membranes, and stillbirths were mainly caused by childbirth, umbilical cord prolapse, uterine rupture and premature delivery. The main causes of early neonatal death were premature birth, neonatal asphyxia, birth defects and placental abruption. Among the deaths, the gestational weeks less than 37 weeks accounted for 55.89%, of which 25 cases were delivered 34 weeks before pregnancy, accounting for 65.79%. CONCLUSION: Perinatal deaths among floating population are the main reasons leading to higher perinatal mortality rate in hospitals than perinatal mortality in this area. Fetal malformations are the first of the clear causes of stillbirths. Premature birth is the leading cause of neonatal death. Need to strengthen the management of mobile pregnant women, strengthen publicity and education, the state free distribution of folic acid and childbirth subsidy policy implemented, to strengthen the delivery assistance to improve the flow of pregnant women, prenatal care and hospital delivery rate; standardized prenatal care to improve fetal prenatal deformity Screening rate and the necessary prenatal diagnosis, early prevention and reduction of fetal malformations, early diagnosis of fetal malformations; increase the perinatal mortality pathological diagnosis to clarify the cause; birth, pediatric cooperation and improve neonatal asphyxia recovery.