摘要
目的分析北京协和医院近5年40例围生儿死亡原因,以改进围生期保健工作。方法根据围生期Ⅰ标准,对本院1999年1月至2003年12月间围生儿死亡病例进行回顾性分析。结果①本院1999年1月至2003年12月围生儿总数为6600,共有40例围生儿死亡,围生儿死亡率为6.06‰。死胎占62.5%(25/40),死产占5%(2/40),新生儿死亡占32.5%(13/40)。②严重的妊娠并发症(重度子痫前期)是引起胎死宫内的最重要的原因(11/25),其次是严重的妊娠合并症(4/25),产前出血(3/25),先天畸形(2/25)等。③死产2例,其中1例为胎儿畸形。④先天畸形是引起新生儿死亡的重要原因,占46.2%(6/13),另一主要原因是由于严重的妊娠并发症或妊娠合并症导致的胎儿宫内缺氧及早产(6/13)。⑤早产是围生儿死亡最主要的相关因素,绝大多数为干预性早产。重度子痫前期是引起围生儿死亡最主要的妊娠并发症,占37.5%。⑥共有9例严重畸形,校正围生儿死亡率为4.70‰。仅3例畸形在产前诊断。⑦40例围生儿死亡中仅16例为本院产前检查,外院产前或无产前检查者占60%。结论本院围生儿死亡率接近发达国家。加强围生保健,提高产前诊断技术,尤其是B超诊断水平,提高各级产科诊疗水平,加强周边地区高危妊娠管理,及时转诊,可进一步降低围生儿死亡率。
Objective To investigate and evaluate the causes of perinatal death in recent five years, aim at improving the quality of perinatal health care and reducing the perinatal morbidity. Methods According to the definition of Perinatal Stage I , the forty cases of perinatal death during Jan. 1999 to Dec. 2003 were retrospectively analysed. Results ①There were 6600 babies delivered at our hospital during the five years, including 40 perinatal deaths. The overall Perinatal Morbidity Rate（PMR） was 6.06 per 1000. The ratio of intrauterine death, stillbirth and neonatal death was 62.5%, 5% and 32.5% respectively.②The leading cause of intrauterine death was severe complication of pregnancy, pre-eclampsia （ 11/25 ）. The other important causes included maternal disease （4/25）, antepartum haemorrhage （ 3/25 ） and congenital malformations （ 2/25 ）.③ There were two still birth , and one of them was congenital malformation . ④46.2% of neonatal deaths were attributed to congenital anomalies, and another 46.2% newborn died of intrauterine asphyxia or prematurity. ⑤Prematurity was the leading correlative factor of perinatal deaths. The leading pregnant complication counting for 37.5% of total perinatal deaths was pre-eclampsia. ⑥There were 9 cases of congenital anomalies, and only 3 cases were diagnosed before birth. The corrected PMR was 4.70‰. ⑦60% of the perinatal death cases didn＇t have the periodic antenatal care at our hospital before admission. When we accepted them from emergency clinic, the results were usually inevitable. Conclusions The PMR of our hospital was close to that of developed countries. To reduce the PMR further, we should pay much attention to enhance perinatal health care and improve the technology of antenatal diagnosis ,especially the accuracy of ultrasound scan. On the other hand, It is very important to strengthen measure of administering high risk pregnancies and collaboration with inferior units.
出处
《中国医刊》
CAS
2006年第1期38-39,共2页
Chinese Journal of Medicine
