33例孕产妇产后出血死亡相关因素分析  

Analysis on related factors of maternal death caused by postpartum hemorrhage in 33 cases

作　　者：曹静[1] 穆春华[2] 梁升连[1] 白希敏 应小燕[1] 

机构地区：[1]南京医科大学第二临床医学院,江苏南京210029 [2]江苏省泗阳县人民医院妇产科 [3]江苏省宿迁市妇幼保健院社区保健科

出　　处：《中国妇幼保健》2014年第33期5386-5388,共3页Maternal and Child Health Care of China

基　　金：江苏省科技厅临床医学专项基金项目〔BL2014095〕

摘　　要：目的：分析导致孕产妇产后出血（PPH）死亡原因及其影响因素,以便采取有效的防治措施,降低孕产妇死亡率。方法：对2004~2013年宿迁市四县一区33例PPH死亡资料进行分析。根据不同的PPH原因、产次、出血量、出血时间、治疗情况、死亡时间、分娩地点、死亡地点等情况,统计各组病例数。结果：PPH导致死亡诸因素中宫缩乏力21例居首位（63.64%）,其次为胎盘因素5例（15.15%）,软产道损伤4例（12.12%）,羊水栓塞3例（9.09%）。33例PPH死亡孕产妇中,经产妇29例,占87.88%,初产妇4例,占12.12%,PPH高峰期在2 h以内25例,占75.76%,死亡高峰期在4 h内22例,占66.67%。基层医院分娩、孕期未产前检查（产检）、发生PPH未能及时救治、及时输血、未能及时转运及盲目转运与PPH死亡密切相关。结论：加强产前保健,提高住院分娩率,提高医疗技术水平,及时抢救,保证充足的血源,及时转诊,是降低孕产妇死亡率的有效措施。Objective： To analyze the causes and influencing factors of maternal death induced by postpartum hemorrhage, so as to take effective prevention and treatment to reduce maternal mortality rate. Methods ： The death data of 33 pregnant women with postpartum hemorrhage in four counties and one district in Suqian city from 2004 to 2013 were analyzed. The numbers of cases were calculated according to different causes, parity, the amount of postpartum hemorrhage, the time of postpartum hemorrhage, treatment, the time of death, place of delivery and place of death. Results：Among the causes, uterine inertia accounted for 63. 64% （21 cases）, ranking the first place, followed by placental factors （5 cases, 15.15% ）, soft birth canal injury （4 cases, 12. 12% ） and amniotic fluid embolism （3 cases, 9. 09% ）. Among 33 cases, 29 cases were multiparous women （87.88%） and 4 cases were primiparous women （ 12. 12% ） ; postpartum hemorrhage peaked within two hours, accounting for 75.76% （25 cases） ; maternal death peaked within four hours, accounting for 66. 67% （22 cases）. Childbirth at primary hospitals, without prenatal examination, slow response to rescue, slow response to timely blood transfusion, slow re- sponse to timely transfer and blind transfer when postpartum hemorrhage occurred were closely related to maternal death caused by postpartum hemorrhage. Conclusion： The measures to reduce maternal mortality rate include strengthening antenatal care, improving hospital delivery rate and medical technology level, timely rescue, ensuring adequate blood resources and timely transfer.

关 键 词：产后出血 孕产妇死亡率 相关因素 干预措施 

分 类 号：R714[医药卫生—妇产科学] R173[医药卫生—临床医学]