【摘要】 目的分析妊娠合并心脏病死亡孕产妇情况及死因,为提出针对性干预措施,降低孕产妇死亡率提供依据。方法对郑州市2006-2015年因妊娠合并心脏病死亡的22例孕产妇相关资料进行回顾性分析。结果 2006-2015年郑州市孕产妇妊娠合并心脏病死亡人数占孕产妇死亡总数的11.11%,心脏病死因素率为2.10/10万,心脏病死因专率由2006-2010年的2.47/10万下降至2011-2015年的1.78/10万。22例合并心脏病构成中,以先天性心脏病(45.45%)、围生期心肌病(18.18%)和风湿性心脏病(13.64%)居前3位。农村妊娠合并心脏病死亡率(2.75/10万)高于城市(1.02/10万)(χ~2=3.893 P=0.048),初中及以下文化程度者占72.73%,家庭年人均收入4 000元以下者占59.09%,产检小于5次者占77.27%,常规服药和定期随访的仅占9.09%,可避免死亡主要归因于个人家庭知识技能态度(87.50%)和县级医疗保健机构知识技能及管理(12.50%)。结论郑州市2006-2010年妊娠合并心脏病是孕产妇死亡的主要原因,要加强健康教育及孕产妇系统管理,增强孕产妇保健意识,提高医务人员技能水平,加强多学科协作,控制妊娠合并心脏病孕产妇死亡的发生。更多还原

【Abstract】 Objective To analyze the status and death causes of pregnancy complicated with maternal heart disease so as to provide a basis for putting forward targeted intervention measures to reduce the maternal mortality. Methods The data of 22 maternal deaths due to pregnancy combined with heart disease in Zhengzhou City from 2006 to 2015 were analyzed retrospectively.Results The deaths from heart diseases in pregnant women accounting for 11.11% of the total maternal deaths. The mortality from heart diseases in pregnant women in Zhengzhou City during 2006-2015 was 2.10/100,000,and it decreased from 2.47/100,000 in 2006-2010 to 1.78/100,000 in 2011-2015. For the 22 maternal deaths,the top 3 heart diseases were congenital heart defects( 45.45%),peripartum cardiomyopathy( 18.18%) and rheumatic heart disease( 13.64%). The mortality was higher in rural areas than in city( 2.75/100,000 vs. 1.02/100,000,χ~2= 3.893,P = 0.048). The deaths with educational background of junior middle school or below,with the family annual income per capita less than RMB 4,000 yuan,with prenatal examination less than 5 times as well as with regular medication and regular follow-up accounted for 72.73%,59.09%,77.27% and 9.09% respectively. The avoidable deaths were mainly attributed to knowledge,skills and attitude of individuals and family( 87.50%) and knowledge,skills and management of county-level medical institutions( 12.50%). Conclusions Pregnancy complicated with heart disease is one of the main causes of maternal deaths in Zhengzhou City during 2006-2015. It is necessary to enhance health education and systematic management of maternal health,improve healthcare awareness of the maternal and skills of medical professionals and strengthen multi-disciplinary collaboration so as to control the occurrence of maternal death in pregnant women with heart disease.更多还原