Andersgaard Alice Beathe, Langhoff-Roos Jens, Øian Pål
Department of Obstetrics and Gynecology, Innlandet Hospital Trust, Gjøvik, Norway.
Acta Obstet Gynecol Scand. 2008;87(8):856-61. doi: 10.1080/00016340802237067.
To report direct maternal mortality ratio (MMR) in Norway between 1976 and 1995 including a description of the underlying complications in pregnancy, the causes of death and assessment of standard of care.
The maternal deaths were identified through the Cause of Death Registry, Statistics Norway, and Medical Birth Registry of Norway. We requested copies of the hospital case records and the maternal death autopsies. The direct maternal deaths were classified on the basis underlying causes and assessed for substandard care according to the guidelines at the time of death and preventability provided optimal conditions and up to date guidelines.
In the period 1976-1995 we identified 61 direct maternal deaths in Norway. The direct MMR was 5.5/100,000 births. Sufficient information was available for analysis in 51 of these cases. Six deaths occurred in early pregnancy. Among the 45 women who gave birth, 32 had a cesarean section, and the death was judged to be related to a complication of the operation in more than half of these cases. The standard of care and the possibility of preventing death were evaluated in 49 cases. Substandard care was observed in 21 of them and 27 were considered avoidable or potentially avoidable.
The direct MMR in Norway was 5.5/100,000 births. The main causes were complications of hypertensive disease of pregnancy and thromboembolism. The majority of maternal deaths were associated with cesarean delivery and considered potentially avoidable.
报告1976年至1995年挪威的孕产妇直接死亡率(MMR),包括描述妊娠相关的潜在并发症、死亡原因以及护理标准评估。
通过挪威统计局死因登记处和挪威医疗出生登记处确定孕产妇死亡病例。我们索取了医院病例记录副本和孕产妇死亡尸检报告。根据潜在病因对直接孕产妇死亡进行分类,并根据死亡时的指南以及在具备最佳条件和最新指南的情况下评估护理是否存在不足以及死亡是否可预防。
在1976年至1995年期间,我们在挪威确定了61例直接孕产妇死亡病例。孕产妇直接死亡率为每10万例分娩5.5例。其中51例有足够的信息可供分析。6例死亡发生在妊娠早期。在45例分娩的妇女中,32例行剖宫产,其中一半以上病例的死亡被判定与手术并发症有关。对49例病例评估了护理标准和预防死亡的可能性。其中21例存在护理不足,27例被认为是可避免或潜在可避免的。
挪威的孕产妇直接死亡率为每10万例分娩5.5例。主要原因是妊娠高血压疾病和血栓栓塞并发症。大多数孕产妇死亡与剖宫产有关,且被认为是潜在可避免的。