Klinik für Geburtshilfe, Universitätsspital Zürich, Frauenklinikstrasse 10, Zürich, Switzerland.
Swiss Med Wkly. 2010 Jan 9;140(1-2):25-30. doi: 10.4414/smw.2010.12768.
The analysis of maternal mortality is an important instrument for quality assurance in Obstetrics and should be accomplished periodically. This study analysed cases of maternal mortality between 1995 and 2004.
The Federal Statistical Office (BFS) provided all death certificates between 1995 and 2004 with an ICD-10 code in the obstetric field (indicated by the letter O). Additionally, all maternal mortality cases from the archive of the Institute of Legal Medicine (IRM), in Zurich, were investigated. All clinics with a maternal mortality case were asked to fill out a detailed anonymous questionnaire. The cases were classified by ICD-10 in direct, indirect and non-pregnancy-related cases.
This study analysed 50 maternal mortality cases. The mean maternal age was 32 years and 50% had foreign nationality. Haemorrhage (including EUG) was the cause of death in 13 women, nine women died of thromboembolism and six women each of preeclampsia or primary infection. Other causes of death were cerebral bleeding, amniotic fluid embolism and others. We classified 32 cases as direct obstetric deaths, which resulted in a direct maternal mortality ratio of 4.15/100000 live births. Direct maternal mortality associated with caesarean section was 0.06 per thousand (11/177000 caesarean sections [average estimate]) and the underreporting was 20%.
Compared to the prior 10-year-period, the maternal mortality ratio decreased from 5.54 to 4.15. The mortality associated with caesarean section decreased 4.5 times. Women at risk are older mothers and those with a non-Swiss nationality, specifically non-Western nationalities. The most common cause of death in this period was haemorrhage, whereas in the previous period most women died of thromboembolism.
对孕产妇死亡率的分析是产科质量保证的一个重要手段，应定期进行。本研究分析了 1995 年至 2004 年期间的孕产妇死亡病例。
联邦统计局（BFS）提供了所有在 1995 年至 2004 年间 ICD-10 产科领域编码为字母 O 的死亡证明。此外，还对苏黎世法医学研究所（IRM）档案中的所有孕产妇死亡病例进行了调查。所有出现孕产妇死亡的诊所都被要求填写一份详细的匿名问卷。病例按 ICD-10 分为直接、间接和非妊娠相关病例。
本研究分析了 50 例孕产妇死亡病例。孕产妇的平均年龄为 32 岁，50%为外国籍。出血（包括 EUG）是 13 名妇女死亡的原因，9 名妇女死于血栓栓塞，6 名妇女各死于子痫前期或原发性感染。其他死亡原因包括脑出血、羊水栓塞等。我们将 32 例归类为直接产科死亡，直接孕产妇死亡率为 4.15/100000 活产。与剖宫产相关的直接孕产妇死亡率为 0.06/千例（177000 例剖宫产中平均估计值为 11 例），漏报率为 20%。
与前 10 年相比，孕产妇死亡率从 5.54 降至 4.15。与剖宫产相关的死亡率下降了 4.5 倍。风险较高的产妇是年龄较大的母亲和非瑞士籍母亲，特别是非西方国家的母亲。本期间最常见的死亡原因是出血，而在前一期间，大多数妇女死于血栓栓塞。
