CAJ | 학술논문

目的：分析影响孕产妇死亡的相关因素,为降低孕产妇死亡率提出干预措施建议。方法回顾性分析广州市花都区2000~2013年孕产妇死亡报表、核实调查报告、病历及死亡评审资料。结果14年中孕产妇死亡65例,平均孕产妇死亡率户籍人口为21.73/10万,全人口为38.45/10万。近14年孕产妇死亡率逐年下降,尤其是流动人口孕产妇死亡率明显降低。死因顺位前3位依次为羊水栓塞、产后出血和妊娠期高血压疾病。2008年及以前涉及非法接生引起的产后出血和羊水栓塞是孕产妇死亡的主要原因,2008年后妊娠合并内科疾病导致的孕产妇死亡不断增加。结论孕产妇死亡受医学和社会诸多因素影响。降低孕产妇死亡率,一是加强流动人口孕期管理,杜绝非法接生；二是加强对急危重症孕产妇救治,进一步提高对异位妊娠的识别诊治水平。
목적：분석영향잉산부사망적상관인소,위강저잉산부사망솔제출간예조시건의。방법회고성분석엄주시화도구2000~2013년잉산부사망보표、핵실조사보고、병력급사망평심자료。결과14년중잉산부사망65례,평균잉산부사망솔호적인구위21.73/10만,전인구위38.45/10만。근14년잉산부사망솔축년하강,우기시류동인구잉산부사망솔명현강저。사인순위전3위의차위양수전새、산후출혈화임신기고혈압질병。2008년급이전섭급비법접생인기적산후출혈화양수전새시잉산부사망적주요원인,2008년후임신합병내과질병도치적잉산부사망불단증가。결론잉산부사망수의학화사회제다인소영향。강저잉산부사망솔,일시가강류동인구잉기관리,두절비법접생；이시가강대급위중증잉산부구치,진일보제고대이위임신적식별진치수평。
Objective To analyze the influencing factors and propose intervention measures for reducing maternal mortality. Methods Data of maternal death reports, verification and investigation reports, summary of medical records, death reviews in Huadu District of Guangzhou from 2000 to 2013 were retrospectively analyzed. Results 65 cases of maternal death in the 14 years with maternal mortality rate of 21. 73/105 in the average household population and 38. 45/105 in the whole population respectively. The maternal mortality rate declined by years, especially that of floating population. The top three causes of maternal death are amniotic fluid embolism, postpartum hemorrhage and hypertensive disorders complicating pregnancy. Postpartum hemorrhage and amniotic fluid embolism involved in illegal deliveries were the main causes of maternal mortality in 2008 and previously. Maternal mortality increased after 2008 caused by pregnancy combined with internal diseases. Conclusions Maternal mortality is affected by medical and social factors. In order to reduce the maternal mortality, firstly is to strengthen the management of pregnancy of floating population and to prevent illegal delivery; secondly is to reinforce the treatment of maternal with emergency and severe diseases, and to improve the diagnosis and treatment of ectopic pregnancy.