Murphy Deirdre J, Charlett Pauline
Division of Obstetrics and Gynaecology, St. Michael's Hospital, University of Bristol, Southwell St., Bristol BS2 8EG, UK.
Eur J Obstet Gynecol Reprod Biol. 2002 May 10;102(2):173-8. doi: 10.1016/s0301-2115(01)00320-7.
To determine the aetiology and outcome of near-miss mortality in obstetrical patients and the subsequent reproductive outcome where fertility is conserved.
Retrospective cohort study of 51,576 women delivered at a University teaching hospital of whom 50 required transfer for critical care.
Over the 12 year study period 1988-1999, 50 women required transfer for intensive care (0.97/1000) and there were three maternal deaths (5.8/100,000). The main indications for transfer were hypertensive disease (32%), haemorrhage (24%) and maternal cardiac disease (24%). The perinatal mortality rate was 14%. Thirty two women conserved their fertility potential and 16 had subsequent healthy liveborn children.
This study of near-miss maternal mortality reminds us of the need for continuing vigilance in the provision of obstetrical care. The successful reproductive outcome highlights the resilience of many women to adverse events in pregnancy but the high loss of fertility potential reflects the physical and psychological morbidity incurred.
确定产科患者中孕产妇险些死亡的病因及结局，以及在保留生育能力情况下的后续生殖结局。
对在一所大学教学医院分娩的51576名女性进行回顾性队列研究，其中50名患者因重症监护需要转院。
在1988 - 1999年的12年研究期间，50名女性因重症监护需要转院（0.97/1000），有3例孕产妇死亡（5.8/100,000）。转院的主要指征为高血压疾病（32%）、出血（24%）和孕产妇心脏病（24%）。围产儿死亡率为14%。32名女性保留了生育能力，其中16名随后生下了健康的活产婴儿。
这项关于孕产妇险些死亡的研究提醒我们，在提供产科护理时需要持续保持警惕。成功的生殖结局凸显了许多女性对孕期不良事件的恢复能力，但生育能力的高损失反映了所遭受的身心疾病。
