摘要
目的 了解剖宫产产妇死亡原因及剖宫产潜在危险性 ,以降低剖宫产产妇死亡率。方法 对上海市 1978～ 1997年间剖宫产产妇死亡病例资料进行回顾性分析。结果 (1) 1978～ 1987年的剖宫产率为 15 .5 5 % (2 5 815 8/ 16 5 9892 ) ,显著低于 1988～ 1997年的 2 9.39% (36 5 376 / 12 43337) ,两者比较 ,差异有极显著性 (P <0 .0 1)。(2 ) 2 0年间产妇死亡 430例 ,其中剖宫产产妇死亡 15 0例 ,占全部死亡产妇的 34 .88%。 (3)剖宫产产妇的死亡率为 2 4.0 5 / 10万 (15 0 / 6 2 35 34 ) ,显著高于阴道产产妇的 12 .2 8/ 10万 (2 80 / 2 2 796 95 )的死亡率 ,两者相比 ,差异有极显著性 (P <0 .0 1)。当剖宫产率大于30 .0 0 %时 ,剖宫产产妇死亡相对危险性上升。 (4)剖宫产产妇死亡原因依次为妊娠高血压综合征 (妊高征 )、心脏病、栓塞 (肺栓塞及羊水栓塞 )、产科出血、肝脏疾病和产褥感染。 (5 )前、后 10年因妊高征死亡的产妇中 ,其剖宫产与阴道产相对危险性有显著降低。 (6 ) 15 0例剖宫产产妇死亡病例中 ,与剖宫产直接相关的死亡有 43例 (2 8.6 7% ) ,其中栓塞最多 ,其次为产科出血、产褥感染及麻醉意外。结论 加强对妊高征、妊娠合并心脏病和栓塞的防治 ,正确掌握剖宫产指征 ,提高手术质量 ,重视术前、
Objective To analyze the causes of maternal deaths of cesarean section and the potential risks of it. Methods A retrospective study on maternal deaths of cesarean section from 1978 to 1997 was carried out. Results (1) The rate of cesarean section in 1978～1987 was 15.55% (258 158/1 659 892),which was significantly lower than that of 29.39% (365 376/1 243 337) in 1988～1997 ( P <0.01). (2) During the 20 years there were 430 cases of maternal deaths in Shanghai. Among them, 150 cases were maternal death after cesarean section which accounted for 34.88%. (3)Maternal mortality rate of cesarean section cases was 24.05/10 5 (150/623 534) which significantly higher ( P <0.01) than that of vaginal delivery, 12.28/10 5 (280/ 2 279 695). The relative risk of maternal deaths in cesarean section group increased when the cesarean section rate was over 30.00%.(4)The rank order of maternal deaths of cesarean section was as follows: PIH (pregnancy induced hypertension), Cardiac diseases, embolisms, haemorrhage, hepatic diseases, and infections.(5)The relative risk of PIH death either for cesarean section or for vaginal delivery was significantly decreased in 1988～1997, compared to the former 10 years. (6) Of 150 cases of maternal deaths of cesarean section, 43 cases (28.67%) were related to the cesarean section with embolism ranking the first, haemorrage the second and infection the third. Conclusions In order to reduce maternal mortality of cesarean section, it is important to pay attention to (1) the prevention and treatment of PIH, heart diseases and embolisms, (2) the indications of cesarean section, (3) improvement of the quality of cesarean section, and (4) pre and post operational management.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2000年第3期153-156,共4页
Chinese Journal of Obstetrics and Gynecology
关键词
剖宫产术
产妇死亡率
死亡原因
Cesarean section
Maternal mortality
Causes of death
