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目的分析妊娠并发心脏病导致孕产妇死亡的主要原因,探讨系统保健管理中的经验和教训,探索降低并发心脏病孕产妇死亡率的相应干预措施。方法对武汉市2000~2013年因妊娠并发心脏病导致死亡的29例死亡孕产妇相关资料进行回顾性分析。结果 2000~2013年武汉市妊娠并发心脏病死亡专率及死因构成比呈上升趋势,2013年常住人口及流动人口妊娠并发心脏病死因构成比分别上升至22.22%及40.00%;29例并发心脏病构成分类中,以先天性心脏病、围产期心肌病和风湿性心脏病居前3位,分别占到44.83%、27.59%和13.79%;妊娠并发心脏病死亡患者保健意识较差,9例不听从医生建议执意坚持妊娠,16例已知自身患心脏病孕妇开展定期监测的仅占25%;可以避免及创造条件可以避免死亡主要归因于个人及家庭态度和知识技能、医疗机构知识技能及管理。结论妊娠并发心脏病导致孕产妇死亡形势严峻,应从广泛宣传、加强风险评估、健全和完善武汉市孕期心脏疾病筛查干预管理、重视产科情况和心脏功能双向监测、严格运动及饮食管理、提高医务人员技能水平等方面加大力度,控制妊娠并发心脏病孕产妇死亡的发生。
Objective To analyze the main causes of maternal mortality caused by heart disease during pregnancy and explore the experience and lessons in systemic health management and explore the corresponding interventions to reduce the maternal mortality rate associated with heart disease. Methods A retrospective analysis was conducted on 29 maternal deaths due to pregnancy-related heart disease from 2000 to 2013 in Wuhan. Results The proportions of deaths and causes of death from pregnancy complicating pregnancy in Wuhan from 2000 to 2013 increased gradually. In 2013, the proportions of death causes of pregnancy complicated by heart disease in resident population and floating population increased to 22.22% and 40.00% respectively. In 29 patients with concurrent heart disease According to the classification, congenital heart disease, perinatal cardiomyopathy and rheumatic heart disease were among the top 3, accounting for 44.83%, 27.59% and 13.79%, respectively. Pregnancy complicated with heart disease patients had poor health consciousness, and 9 patients Not obedient to the doctor’s advice Insisting on pregnancy, 16 cases known to have heart disease Pregnant women carry out regular monitoring of only 25%; can avoid and create conditions to avoid death mainly due to personal and family attitudes and knowledge and skills, medical institutions knowledge and skills And management. Conclusions Pregnancy complicated by heart disease leads to severe maternal death. Extensive publicity should be carried out to strengthen risk assessment, improve and perfect Wuhan intercourse heart disease screening intervention management, attach importance to obstetrics and cardiac function bi-directional monitoring, strict exercise and diet management, improve medical care Personnel skills and other aspects of efforts to step up efforts to control the pregnancy complicated by heart disease maternal deaths.