The Investigation Of Maternal's Care

Objective:To investigation and study the situation related to maternal deaths,to dicuss which service are apply in parturition and trend of antenatal care in seven citys in Shangxi province in 2003～2005.Analysis on main characteristics of the deadly cases,shortingcoming in parturition and antenatal care,and come up with the promoting countermeasures.Method:Reviewed analysis and sampling survey deadly and parturient case.Result:1.The maternal mortality rate(MMR)is going down,the causes of maternal deaths in succession were obstetric haemorrhage,amniotic fluid embolism,pregnant induced hypertension.MMR is higher in without planned villagal mater.2.The hospital delivery rate is rising trend in recent years in Shangxi province.Caesarean section rate is steady increasing,it was 23.59%in 2005.The rate in provincial hospital was higer in county hospital The main causes were social factors,fetal distress,abnormal position of fetus and cephalopelvic.Social fators rank first indication,the rate is 18.63%.The operative vaginal delivery and episiotomy rate are 7.26%,14.83%.How to decide the type of operative vaginal delivery and whether or not to chose mediolateral episiotomy existed statistics discrepancy in different level hospitals,it was maybe related to obstetric quality and the skill,conception of the obstetrician.Now in Shangxi province the intering measures in spontaneous vaginal delivery are distinct different form WHO recommend Care in Normal birth:a practical guide.Safe motherhood practical guide.Effective accompanied delivery and pain relief in labor were rarely be provided.Obstetrian all attach the important and commonly obstric complications--postpartum hemorrhage,pre-eclampsia and eclampsia,obstructed labor,and also can actively handel.But frequently Mgso₄ and partographic.cannot used properly.3.Now in Shangxi province the latter maternity care is provided with inadequate and outdated technology,equipment and personnel.The quality and quantity of antenatal care isnot good,enough,especial some extreme important checkup items were ignored.74.06%of the women received less of 5 times the checkups.Factors analysis showed that education factors would influence women's antenatal health care utilization.In the basic antenatal checkup items,Ultrasound checkup and belly checkup were most common,about 90%of the women receieved them.And the rate of Ultrasound checkup was nealy 99%.Blood and urine were rarely examed at root level,the rate of examination was only about 20%.Conclusions:Providing efficient systematic management of the pregnancies,enforcing easily and good quality antenatal care;Increasing hospital deliveries,raising the quality of obstetrics,decreasing the cesarean section and mastering the indications appropriately,diagnosing and curing obstric complications correctly and timely;Spreading WHO recommend Care in Normal birth:a practical guide.Safe motherhood practical guide and former prenatal care model;Adding capital,improving equipments and training adequate medical ground personnels in maternal heath care,especial at root level are important points to descrease MMR.