上海市妊娠风险预警评估管理现状

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目的:了解全市妊娠风险预警评估管理全面开展后的实施状况,为改进管理方案提供依据。方法:2012年6~7月对全市18个区县妇幼保健所及辖区社区卫生服务中心进行全面现况调查。结果:全市18个区县妇幼保健所59.0%妇保人员、242家社区卫生服务中心81.9%社区妇保人员从事妊娠风险预警管理,人均用于妊娠风险管理时间分别为6.2 h/周和11.2h/周。区县妇幼保健所及社区卫生服务中心参与妊娠风险管理人员接受专项培训的覆盖率分别为100.0%和99.2%,医院平均培训时间为2.7 h,社区平均培训时间为3.8 h。区县妇幼保健所对接产医院和社区的平均质控次数分别为5.6和6.6次,随机抽查由区县妇幼保健所管理的168例高风险重点孕妇,其中红色15例(8.9%)、紫色5例(2.9%)、橙色148例(88.1%),平均随访4.1次(本市4.4、外地3.9次)。社区卫生服务中心初筛阳性及时转出率为89.0%,转诊单从医院返回社区平均时间为两周,社区对确诊的重点孕妇随访率达100.0%。结论:上海市的妊娠风险预警评估管理已入规范运行,需要加强队伍建设及信息化建设以促进该项工作的可持续、高效化进展。“,”Objective:To understand the implementation status of pregnancy risk warning after evaluation and management of pregnancy risk warning in Shanghai,and provide a basis for improving management measurement.Methods:From June to July in 2012,18 maternal and child health(MCH) institutes at district(county) level and community health service centers in Shanghai were investigated comprehensively.Results:Among 18 MCH institutes at district(county) level,59.0% of medical workers were occupied in maternity and child care;among 242 community health service centers,81.9% of medical workers were occupied in management of pregnancy risk warning,the mean times per capita used for management of pregnancy risk warning were 6.2 hours per week and 11.2 hours per weeks,respectively.The coverage rates of special training among the medical workers occupied in management of pregnancy risk warning in MCH institutes at district(county) level and community health service centers were 100.0% and 99.2%,respectively;the mean training times of them in hospitals and community were 2.7 hours and 3.8 hours.The mean times of quality control in hospitals and community from MCH institutes at district(county) level were 5.6 times and 6.6 times;168 high risk important pregnant women were selected from MCH institutes at district(county) level,including 15 pregnant women of red alert(8.9%),5 pregnant women of purple alert(2.9%),148 pregnant women of orange alert(88.1%),the mean times of follow-up was 4.1 times(resident pregnant women: 4.4 times;migrant pregnant women: 3.9 times).The timely transfer rate of pregnant women with positive results of primary screening in community health service centers was 89.0%,the mean return time of transfer document from hospitals to community was two weeks,the follow-up rate of key pregnant women in community was 100.0%.Conclusion:Evaluation and management of pregnancy risk warning in Shanghai has already been operated regularly,team construction and information construction should be strengthen to promote sustainable and efficient progress of the work.
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