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目的:分析上海市开展妊娠风险预警评估管理的实施情况和初步效果,发现存在的问题,并提出改进建议。方法:通过文献查阅和专家论证制定《妊娠风险预警评估筛查表》、《妊娠风险预警评估分类表》以及分级管理方案,并收集分析方案实施后半年的相关个案和报表以及现场问卷调查资料。结果:全市2010年1～6月使用《妊娠风险预警评估筛查表》后发现阳性孕妇17 069名,初次筛查阳性率22.3%;使用《妊娠风险预警评估分类表》后,疾病确诊10 382人,确诊率65%,其中高风险(红、橙、紫色)孕妇占6.6%,发现17例不宜继续妊娠孕妇并及时进行引产或剖宫产终止妊娠,从而直接避免了这些极有可能发生的孕产妇死亡。结论:妊娠风险预警评估管理实施以来取得初步成效,尤其孕产妇死亡率得到有效控制。但是方案还需进一步细化,急需促进信息平台的建设有利于提高管理效率。
OBJECTIVE: To analyze the implementation and preliminary results of the early warning assessment and management of pregnancy risk in Shanghai, find the existing problems and propose suggestions for improvement. Methods: Through the literature review and expert argumentation, the “Risk Screening for Pregnancy Risk Assessment”, the “Pregnancy Risk Warning Assessment Classification Table” and the classification management plan were formulated. Relevant cases and reports of the six months after the implementation of the project were analyzed and field survey data were collected. Results: There were 17 069 positive pregnant women in the first six months of 2010 after using “Pregnancy Risk Early Warning Evaluation Screening Table”, and the positive rate of initial screening was 22.3%. After the classification of early warning of pregnancy risk was used, the diagnosis of disease was 10 382 People, the diagnosis rate of 65%, of which 6.6% of the high risk (red, orange, purple) pregnant women found 17 cases should not continue to pregnant women and timely induced labor or cesarean termination of pregnancy, which directly to avoid these highly likely Maternal death. Conclusion: The preliminary results have been achieved since the implementation of the early warning assessment of pregnancy risk. In particular, the maternal mortality rate has been effectively controlled. However, the program needs to be further elaborated. The urgent need to promote the construction of information platform is conducive to improving management efficiency.