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目的分析北京市大兴区202例重症高危妊娠孕产妇危险因素,为科学有效的管理提供依据。方法选取2014年10月—2015年9月北京市大兴区20家地段保健站、10家助产机构产科门诊接收的重症高危妊娠孕产妇202例,按照《北京市孕产妇危险因素分类标准》及《北京市大兴区高危孕产妇管理工作规范》进行筛查管理。按照本市、外地户籍进行分类,分别统计孕妇年龄、建册时间、孕产史、发病时间、上报部门、转归、产检次数,统计各危险因素的情况、发生率及不同妊娠结局的情况和构成比。结果 202例重症高危孕妇中,外地户籍116例,占55.50%。≤18岁的早育孕产妇外地户籍占0.99%,高于本市户籍;高龄孕产妇外地户籍占7.42%,高于本市户籍的4.46%;再孕经产孕产妇外地户籍占34.65%,高于本市户籍的18.32%;孕早期建册外地户籍占22.77%,低于本市户籍的35.64%;产检次数<8次外地户籍占2.48%,高于本市户籍;产检次数12次以上外地户籍占17.33%,低于本市的26.73%。重症高危妊娠14种危险因素中,前5位危险因素依次是:妊娠期高血压疾病,妊娠期甲状腺疾病,妊娠期糖尿病,前置胎盘,妊娠合并血液疾病。筛查发现孕中期和孕晚期重症高危妊娠占78.20%。202例重症高危孕妇全部安全结束妊娠,其中安全分娩186例,占92.08%,无孕产妇及围生儿死亡。结论加强流动人口孕产妇保健管理和助产机构管理,严格筛查并关注动态危险因素,加强婚前和孕早期健康教育,普及避孕、优生优育、健康生活方式、高度重视产前检查等知识,强化执行三级管理制度,是做好高危妊娠管理工作的重点环节,也是降低孕产妇病死率的有效措施。
Objective To analyze the risk factors of maternal mortality in 202 cases of severe and high risk pregnancy in Daxing District, Beijing, and provide the basis for scientific and effective management. Methods Totally 202 pregnant women with severe and high risk received from 20 health stations in 20 districts of Daxing District of Beijing and 10 obstetrics and gynecology clinics from October 2014 to September 2015 were selected. According to “Beijing Classification Standard of Maternal Risk Factors” and “Daxing District, Beijing high-risk maternal management practices” for screening management. In accordance with the city, the field of household registration for classification, respectively, statistics on the age of pregnant women, build time, maternal history, the onset time, reporting departments, prognosis, the number of births, the statistics of the risk factors, incidence and different pregnancy outcomes and Composition ratio. Results Among 202 cases of severe and high risk pregnant women, 116 were registered permanent residents in the field, accounting for 55.50%. Pregnancy maternal age ≤18 years old accounted for 0.99% of the household registration, higher than the city household registration; elderly maternal field register accounted for 7.42%, higher than the city’s household registration 4.46%; remarriage through maternity maternity account for 34.65%, high Accounting for 18.32% of the registered permanent residence in the city; accounting for 22.77% of the registered permanent residents in the first trimester and 35.64% of the registered permanent residents in the city; Household accounted for 17.33%, lower than the city’s 26.73%. Among the 14 risk factors of severe high-risk pregnancy, the top 5 risk factors were as follows: gestational hypertension, thyroid disease during pregnancy, gestational diabetes mellitus, placenta previa and pregnancy with blood diseases. Screening found that in the second trimester and third trimester severe high-risk pregnancy accounted for 78.20%. 202 cases of severe high-risk pregnant women all the safe end of pregnancy, of which 186 cases of safe delivery, accounting for 92.08%, no maternal and perinatal deaths. Conclusion To strengthen the maternal health management and midwifery management of floating population, strictly screen and pay attention to the dynamic risk factors, strengthen premarital and early pregnancy health education, popularize contraception, prenatal and postnatal care, healthy lifestyle, attach great importance to prenatal care and other knowledge, strengthen The implementation of the three-level management system is a key link in the management of high-risk pregnancies and an effective measure to reduce maternal mortality.