【摘要】 目的了解湖南省不可避免孕产妇死亡的相关影响因素,为预防和干预提供参考。方法对2016~2018年间湖南省省级评审结论为不可避免死亡孕产妇个案病例资料进行回顾性分析,所有个案资料经省级孕产妇死亡评审专家组分析评审,按全国统一使用的孕产妇死亡十二格表分析死亡原因以及死亡主要影响因素。结果湖南省不可避免死亡孕产妇死因以间接产科死因为主,占74.07%,间接产科死因前三位分别为妊娠合并神经系统疾病(16.05%)、猝死(14.81%)、肺栓塞(13.58%)。直接产科死因主要由羊水栓塞引起(22.22%),高龄为第一位高危因素,占36.84%;瘢痕子宫为第二位高危因素,占33.33%;死亡主要发生在分娩后,占58.02%,其中产后2 h内死亡占21.28%; 24 h内死亡占46.81%;产后1周内死亡占70.21%;产后2周内死亡占91.48%。结论湖南省不可避免孕产妇死亡主要由间接产科死因所致,需重视间接原因导致的产科合并症风险,加强孕期高危因素筛查和管理,加强多学科联合,提高综合救治能力,以减少不可避免孕产妇死亡。更多还原

【Abstract】 Objective To understand influencing factors of inevitable maternal mortality in Hunan Province,so as to provide reference for relevant preventive and interventive measures. Methods Clinical data of inevitable maternal deaths in Human Province from 2016 to 2018 were collected for retrospective analysis. All case data were analyzed by the provincial maternal death review expert panel,and the major causes of death were analyzed by the national standard Maternal Death 12-square Table. Results Among inevitable maternal deaths,74. 07% were largely due to indirect obstetric cause,including neurological diseases（16. 05%）,sudden death（14. 81%）and thromboembolic diseases（13. 58%）; The direct cause of obstetric death was mainly caused by amniotic fluid embolism（22. 22%）; old age was the first risk factor,accounting for 36. 84%; scar uterus was the second high risk factor,accounting for 33. 33%; the death mainly occurred after delivery,accounting for 58. 02%. The death rate at 2 h,24 h,1 week,and 2 weeks after delivery were 21. 28%,46. 81%,70. 21%,and 91. 48% respectively. Conclusion The inevitable maternal deaths in Hunan Province were mostly caused by indirect obstetric cause. It is necessary to pay attention to the risk of obstetric complications caused by indirect causes,strengthen the screening and management of high-risk factors during pregnancy,strengthen multidisciplinary cooperation,and improve the ability of comprehensive treatment,to reduce the inevitable death of pregnant women.更多还原