Optimising The Screening Model For High Risk Pregnancy

[Objective] To explore a new screening model for high risk pregnancy so as to improve the management quality of the target population in pregnancy.[Methods] Data consultation and questionnaire were used to know the status of screening for high risk pregnancy in shanghai. Basing on the status, a new screening scheme for high risk pregnancy called key disease screening was researched and applied to some pilot study areas in every administrative district in shanghai. Comparison of management effects of screening for high risk pregnancy in pre and post implementation of the new scheme (Apr-Jun 2008 vs Apr-Jun 2009) was made to evaluate its advantages.[Results] After the new screening scheme for high risk pregnancy implementation, (1) The screening rate of high risk disease in community health service centers and maternity hospitals decreased from 34.00% and 29.10% to 2.24% and 1.60%; (2) The proportion of dynamic risk factors in community health service centers and maternity hospitals increased from 14.24% and 16.80% to 17.90% and 19.78% (P< 0.01); (3) The major diseases screened out by community health service centers and maternity hospitals changed from abortion≥2 times, age≥35 years and scarred uterus to heart disease, hypertensive disorders, diabetes mellitus and hyper/hypo-thyroidism; (4) The feedback rate of cards for referral increased from 47.64% to 81.05% (P< 0.01), the timeliness rate for the follow-up visits increased from 84.78% to 96.90% (P< 0.05), and the rate of implement for the follow-up visits increased from 82.61% to 95.35% (P< 0.05); (5) The medical staff and high risk pregnant women provided higher satisfaction to the new screening scheme for high risk pregnancy.[Conclusions] The key disease screening scheme has improved the clinical value of screening, increased the management benefit of referral and follow-up, and promoted the quality improvement of systematic management for high risk pregnancy.