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目的:分析妊娠合并内外科疾病导致孕产妇死亡的主要原因,探索降低孕产妇死亡率的相应干预措施。方法:对武汉市2001~2012年孕产妇死亡监测资料中26例妊娠合并内外科疾病导致死亡的病例进行回顾性分析。结果:2001~2012年武汉市孕产妇平均死亡率为14.45/10万,妊娠合并内外科疾病的死亡专率为4.13/10万,近年妊娠合并内外科疾病的死亡专率处于4/10万~5/10万的平台期,死因顺位中妊娠合并内外科疾病位次逐渐前移,2010~2012年已居于首位。孕产期保健服务接受不到位、孕妇及家人知识技能和态度问题、医疗机构技术态度问题是导致妊娠合并内外科疾病病例死亡的主要原因。结论:妊娠合并内外科疾病导致孕产妇死亡形势严峻,为进一步控制孕产妇死亡率,需从强化早期监控、加强高危管理,建立孕期心脏疾病筛查干预机制,加强保健服务人员能力建设及扩大宣传教育等方面加大力度。
OBJECTIVE: To analyze the main causes of maternal mortality caused by medical and surgical diseases during pregnancy and explore corresponding interventions to reduce the maternal mortality rate. Methods: A retrospective analysis of 26 cases of maternal deaths caused by pregnancy and surgical diseases in the monitoring data of maternal mortality from 2001 to 2012 in Wuhan City was conducted. Results: The average maternal death rate was 14.45 / lakh in Wuhan from 2001 to 2012. The death rate of intrauterine and gynecological diseases in pregnancy was 4.13 / lakh. In recent years, the death rate of intracranial and surgical diseases in pregnancy was between 4 / 5/10 million platform period, the sequence of causes of death in pregnancy and surgical surgeries gradually move forward position, 2010-2012 has been the first place. Maternal and child health care services are not in place, pregnant women and their families knowledge and skills and attitudes, medical institutions, technical attitude is the leading cause of death in pregnancy and surgical diseases combined with the main reasons. CONCLUSIONS: Maternal deaths caused by pregnancy and surgical diseases are severe. To further control the maternal mortality rate, we need to strengthen early surveillance, strengthen high-risk management, establish a screening intervention mechanism for heart disease during pregnancy, strengthen the capacity building and publicity of health service personnel Education and other efforts to increase.