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目的:调查北京市东城区辖区医院1997～2006年孕产妇死亡情况,探讨孕产妇死亡的主要原因及变化趋势,寻求降低孕产妇死亡的有效途径.方法:对10年间辖区医院产科死亡的27例孕产妇监测资料进行回顾性分析,对前5年和后5年的孕产妇死亡率和死因进行比较.结果:辖区医院产科10年总活产数104 858人次,孕产妇死亡27例,死亡率为25.75/10万;前5年孕产妇死亡率为45.02/10万,后5年孕产妇死亡率为13.87/10万;主要死因构成为妊娠期高血压疾病、妊娠期肝病、产科出血、羊水栓塞、心脏病、脑出血、宫外孕,妊娠期高血压疾病和妊娠期肝病分别为第一、二位死因,死亡孕产妇的直接产科原因占59.26%;死亡孕产妇中围产期未进行系统保健的占55.56%,外地流动人口占62.96%.结论:东城区辖区医院10年来孕产妇死亡率呈下降趋势,死因顺位亦发生变化,妊娠期肝病已超过妊娠期高血压疾病成为第一位死因;外地流动人口围产期不进行系统保健已对围产保健质量构成威胁,孕产妇系统管理如何有效覆盖流动人口已经成为该区所面临的主要问题;提高医疗机构处理妊娠合并症的急救抢救能力,也是今后围产工作的重点.“,”Objective: To observe the maternal mortality of Dongcheng District in Beijing from 1997 to 2006, explore the main death causes and changing trend and find an effective way to reduce the maternal mortality. Methods: The monitoring data of 27 maternal deaths from 1997 to 2006 were analysed retrospectively, the maternal mortality and death causes were compared between the first five years and the second five years. Results: From 1997 to 2006, there were totally 104 858 cases of live births and 27 eases of maternal deaths, the maternal mortality was 25.75/100 000. The maternal mortalities in the first five years and the second five years were 45. O2/100 000 and 13. 87/100 000; the main death causes were hypertensive disorder complicating pregnancy, liver disease during pregnancy, obstetric hemor-rhage, amniotic fluid embolism, heart disease, cerebral hemorrhage and ectopic pregnancy, the first death cause was hypertensive disorder complicating pregnancy and the second was liver disease during pregnancy. The percentage of direct obstetric causes of maternal deaths was 59. 26%. The percentage of maternal deaths without systemic perinatal health care was 55.56%, and ecdemic population accounted for 62.96%. Conclusion: The maternal mortality of Dongcheng District declined in the past ten years and the position of death causes changed also. Liver disease during pregnancy is the first death cause beyond hypertensive disorder complicating pregnancy. It affects the quality of perinatal health care that the eedemic population doesnt take systemic health care in perinatal period. How to effectively cover the ecdemic population by the maternal management system is the main problem faced by Dongcheng District. It is also the key point that following perina-tal work to improve the first-aid salve ability of medical treatment organization dealing with pregnancy incorporated diseases.