Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Women's Health, University of Louisville, Louisville, KY 40202, USA.
Curr Opin Obstet Gynecol. 2013 Apr;25(2):117-23. doi: 10.1097/GCO.0b013e32835e1505.
To review the recent literature regarding maternal mortality, especially in developed countries, and to provide suggestions for clinical action addressing the rising trend.
Worldwide maternal deaths declined over the past 20 years; however, it is unlikely that the United Nations' Millennium Development Goal 5 for a 75% reduction in maternal mortality by 2015 will be achieved. Ninety-nine percent of the annual preventable maternal deaths from complications of pregnancy and childbirth occur in developing countries, particularly sub-Saharan Africa. In developed countries, including the United States, numerous strategies have developed to recognize the factors leading to maternal death and to implement systems' changes allowing interventions. In many cases, maternal death is avoidable but oftentimes a patient is saddled with life-long medical consequences. Near-misses are increasing which place a burden not only on the family but also on the healthcare system and overall community.
The United States has a rising trend in maternal deaths. To achieve a reduction within all developed countries there must be coordinated death review activities that investigate every case along with near-misses. Recommendations for changes within the medical system will continue to improve maternal health not only in developed countries but also worldwide.
回顾近期关于孕产妇死亡率的文献，尤其是发达国家的情况，并为应对这一上升趋势提供临床行动建议。
过去 20 年来，全球孕产妇死亡率有所下降；然而，联合国 2015 年实现孕产妇死亡率降低 75%的千年发展目标 5 似乎不太可能实现。每年因妊娠和分娩并发症导致的可预防孕产妇死亡中，有 99%发生在发展中国家，特别是撒哈拉以南非洲地区。在发达国家，包括美国，已经制定了许多策略来识别导致孕产妇死亡的因素，并实施系统变革以进行干预。在许多情况下，孕产妇死亡是可以避免的，但患者往往会留下终身的医疗后果。接近死亡的病例越来越多，这不仅给家庭带来了负担，也给医疗保健系统和整个社区带来了负担。
美国的孕产妇死亡率呈上升趋势。为了在所有发达国家实现降低孕产妇死亡率的目标，必须开展协调的死亡审查活动，对每一例死亡病例和接近死亡的病例进行调查。对医疗系统的改革建议将继续改善发达国家和全球的孕产妇健康。
