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目的回顾性分析妊娠晚期死胎原因,提出预防对策,以减少胎死宫内的发生,从而降低围产儿死亡率。方法采用回顾性分析方法对上海市长宁区接产医院2010年1月-2014年12月收治的妊娠28周后死胎134例进行回顾性分析。结果上海市长宁区接产医院2010年1月-2014年12月围产儿数为78 536,死胎发生率总体呈下降趋势,平均死胎率为1.71‰。死胎的发生前四位原因主要是胎儿因素(48例,35.82%)、不明原因(26例,19.40%)、脐带因素(23例,17.16%)、胎盘因素(17例,12.69%)。结论加强围生期保健和健康教育,契合区域卫生改革,提高孕产妇系统保健;加强高危妊娠的监护管理,发挥特色功能;提升学科人才队伍建设,建立母婴健康管理新模式,有助于降低妊娠晚期胎死宫内的发生率。
Objective To retrospectively analyze the causes of stillbirths in the third trimester of pregnancy and to put forward the preventive measures to reduce the incidence of fetal death in the womb so as to reduce the perinatal mortality rate. Methods A retrospective analysis was performed to retrospectively analyze 134 cases of stillbirth after 28 weeks’ gestation from January 2010 to December 2014 in Changning District of Shanghai. Results From January 2010 to December 2014, the number of perinatal children in Changning District Dispensary Hospital in Shanghai was 78 536. The incidence of stillbirths showed a general downward trend with an average of1.71% of stillbirths. The first four causes of stillbirth were fetal factors (48 cases, 35.82%), unexplained causes (26 cases, 19.40%), umbilical cord factors (23 cases, 17.16%) and placental factors (17 cases, 12.69%). Conclusions Strengthen perinatal health care and health education, accord with regional health reform and improve maternal system health care. Strengthen custody management of high-risk pregnancy and give play to its special functions. Improve the construction of disciplinary personnel and establish a new mode of maternal and infant health management, which helps to reduce The incidence of intrauterine pregnancy in late pregnancy.