【摘要】 目的 :了解上海市孕产期系统保健现状 ,为改进工作提供决策依据。方法 :采用现况调查方法 ,分别对服务需方(孕产妇 )和供方 (医务人员 )进行问卷调查及对病案的查阅。结果 :1外来孕产妇占全市分娩总数的 30 % ;2孕产妇的平均年龄为 2 6岁 ,初次妊娠孕产妇为 5 5 % ,孕期平均体重增加为 15 kg;3建立“孕产妇健康手册”率为 86 .1% ,平均建册时间为 13.71周 ,其中 <13周的建册率为 6 5 .8%。 4平均产前检查次数为 8.0 7(其中本市为 9.0 7,非本市为 5 .76 ) ,产前检查的平均费用为 1133.6 3元 ,产前检查的医院以二级综合性为主 ( 4 9.3% ) ,乡卫生院最少 ( 3.7% )。 5有产前诊断指征者占 6 .0 % ,但进行羊水穿刺的仅占 0 .4 %。按要求在 18～ 2 4周接受 B超大畸形筛查者占 78.8%。 6以剖宫产为分娩方式者最多 ( 5 7.4 % ) ,前 3位指征分别为胎儿窘迫、社会因素、头盆不称 ;孕产妇对剖宫产好处的认识为痛苦少、安全、不影响体形 ;7平均住院天数为 6 .83d,剖宫产明显长于阴道产 ( 8.17/ 5 .4 9,P<0 .0 1) ;平均住院费用为 32 39.83元 ,剖宫产显著高于阴道产 ( 4 332 .4 5 / 2 14 6 .11,P<0 .0 1)。 8孕产妇贫血为最常见的疾病 ,其中孕期贫血发生率 9.8% ,产褥期贫血为 13.9% ) ;其次为妊高征 ( 5 .5 % ) ;92更多还原

【Abstract】 Objective:To learn the situation of systematic maternal health care so as to improve the quality of care Methods:using unified questionnares to interview the pregnant women ,new mothers and medical staff face to face Case history was also reviewed Results:①Floating population account for 30%;②the average age of pregnant women was 26,with primigravida accounted for 55% The average weight gain was 15 kg;③86 1% owned “Maternal health handbook" which should be issued as routine at registration for first antenatal check up The average time of issuing was 13 71 gestational weeks,with early registration ( P <13 weeks ) rate of 65 8%;④The average antenatal check up was 8 07 with the average cost of 1 133 63 yuan Antenatal check up was mainly performed in the secondary general hospital(49 3%)with the minimum of township hospital (primary health center);⑤Although 6% had the indications for prenatal diagnosis, only 0 4% received amminotic puncture The coverage rate of scanning on major malformations by ultrasound B during 18~24 gestational weeks was78 8%;⑥Cesarean section rate was 57 4% Asphyxia, non medical factors and CPD were the main indications of cesarean section There were misunderstanding on the benefits of cesarean section among pregnant women;⑦The average hospital stay after delivery was 6 83 (cesarean section/ vaginal delivery 8 17/5 49, P <0 01) with the average cost of 3 239 83 yuan(cesarean section/vaginal delivery 4 332 45/2 146 11, P <0 01);⑧Anemia was the most common diseases with the incidence of 9 8% for pregnant women and 13 9% for postpartum women PIH incidence was 5 5%;⑨The average birth weight of newborns was 3 345 g(male/female 3 389 56/3 291 51),with the incidence of macrosomia(≥4000)7 8%;1091 6% newborns were breastfed before discharging from hospital and 67 7% were exclusive breastfeeding Conclusion:The problems remained include the low early registration, low coverage of prenatal diagnosis, misunderstanding for cesarean section, high rate of cesarean section and high incidence of macrosomia Therefore, paying more attention on early pregnancy healthcare, prenatal diagnosis, health education was in urgent need更多还原