Evaluation on function of risk early warning system for maternal near miss in Shapingba district of Chongqing city

LI Hong-yu; WANG Dan; LUO Yuan; DONG Xiao-jing; ZHANG Hua; CHANG Qing; HU Li-na

doi:10.19538/j.fk2017090116

Abstract：Objective To promote the treatment for maternal near miss and to further reduce maternal mortality.Methods According to survey results of obstetric quality of 13 midwifery institutions,changes of relevant indicators (total number of pregnant women,incidence of maternal near miss,maternal mortality,cesarean section rate,rate of postpartum hemorrhage,neonatal mortality rate)in recent 3 years were analyzed,including before and after January 2015 when risk early warning system worked.Etiopathogenisis of maternal near miss and causes of maternal death were also analyzed.The defects of risk early warning system during the 2 years of working were investigated.Results From 2014 to 2016,the total number of pregnant women in Shapingba district increased year by year (16,359/17,311/19,014).Meanwhile,incidence of maternal near miss was increasing (27.72％,38.29％,39.05％) with significantly statistical difference (x2=3.819,P=0.031);maternal mortality was decreasing[(42.79/100,000) (28.88/100,000) (5.26/100,000)]with significantly statistical difference (x2=5.104,P=0.018);cesarean section rate and rate of postpartum hemorrhage were on the decline respectively (48.30％,47.84％,47.21％;2.22％,2.14％,2.05％) with no significantly statistical difference (x2=0.643,P=0.575;x2=1.446,P=0.228);neonatal mortality rate was decreasing (1.58％,0.90％,0.69％) with significantly statistical difference (x2=4.761,P=0.023).Both the first etiopathogenisis of maternal near miss and the first cause of maternal death were pregnancy complicated with internal and/or surgical diseases.The defects of risk early warning system during the 2 years were insufficient risk assessment,dynamic evaluation,and improper patient referral and patient transportation.Conclusion Risk early warning system is obviously effective in Shapingba district,which plays on important role in enhancing success rate of treatment for maternal near miss and reducing maternal mortality.So this warning system deserves to be improved and promoted.