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目的:了解妊娠期高血压疾病致孕产妇死亡的影响因素,制定干预措施,减少并发症,降低妊娠期高血压疾病所致孕产妇死亡。方法:回顾性分析海南省1996～2008年50例妊娠期高血压疾病致孕产妇死亡病例的临床资料。结果:50例妊娠期高血压疾病患者中,小学及以下文化程度26例(占52.00%),家庭年人均收入1 000元以下18例(占36.00%),产前检查(产检)5次以上11例(占22.00%);并发症:50例死亡病例中发生子痫13例,脑血管意外18例,胎盘早剥子宫卒中4例,产后出血DIC 11例,HELLP综合征9例,心、肾功能衰竭11例;可避免死亡47例(占94.00%),其中16例(占34.04%)因医疗保健部门治疗、处理不当所致。结论:加强群众健康教育,开展孕产妇危险因素筛查和分级管理,提高妊娠期高血压疾病的早期识别能力及就地抢救的能力,进行规范化处理,不断提高产科服务质量和加强产科能力建设,进一步加强对危重孕产妇的疑难病例讨论制度和会诊制度,以降低妊娠期高血压疾病所致孕产妇死亡。
Objective: To understand the influencing factors of maternal mortality caused by hypertensive disorder complicating pregnancy and to make interventions to reduce the complications and reduce the maternal mortality caused by hypertensive disorders during pregnancy. Methods: The clinical data of 50 maternal deaths caused by hypertensive disorders of pregnancy during 1996-2008 in Hainan Province were retrospectively analyzed. Results: Among 50 cases of hypertensive disorder complicating pregnancy, there were 26 cases (52.00%) with primary and below education level, 18 cases (36.00%) with annual per capita income below 1000 yuan, and more than 5 times prenatal examination 11 cases (22.00%); complications: 50 cases of death occurred in 13 cases of eclampsia, cerebrovascular accident in 18 cases, placental abruption in 4 cases of uterine bleeding, 11 cases of postpartum hemorrhage DIC, HELLP syndrome in 9 cases, There were 11 cases of renal failure and 47 cases of death (94.00%) were avoided. Of them, 16 cases (34.04%) were treated by the health care department and were not handled properly. Conclusion: To strengthen the health education of the masses, to carry out the screening and grading management of maternal risk factors, to improve the ability of early identification of hypertensive disorders in pregnancy and rescue in situ, to standardize the treatment, to continuously improve the quality of obstetric services and to enhance obstetrical capacity building, To further strengthen the critical cases of critical maternal discussion system and consultation system to reduce gestational hypertension caused by maternal mortality.