Shamshirsaz Amir A, Dildy Gary A
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, Houston, Texas.
Clin Obstet Gynecol. 2018 Jun;61(2):359-371. doi: 10.1097/GRF.0000000000000370.
Throughout most of the 20th century, the risk of maternal mortality in high resource countries decreased dramatically; however, this trend recently has stalled in the United States and appears to have reversed. Equally alarming is that for every reported maternal death, there are numerous severe maternal morbidities or near misses. Shifting maternal demographics (eg, obesity, advanced maternal age, multifetal pregnancies), with attendant significant medical comorbidities (eg, hypertension, diabetes, cardiac disease) and the increase in cesarean deliveries significantly contribute to increased maternal morbidity and mortality. This chapter focuses on the role of critical care in reducing maternal mortality and morbidity.
在20世纪的大部分时间里,资源丰富国家的孕产妇死亡风险大幅下降;然而,这一趋势最近在美国停滞不前,而且似乎已经逆转。同样令人担忧的是,每有一例报告的孕产妇死亡,就会有许多严重的孕产妇发病情况或险些发生的死亡情况。孕产妇人口结构的变化(如肥胖、高龄孕产妇、多胎妊娠),以及随之而来的重大医疗合并症(如高血压、糖尿病、心脏病)和剖宫产率的上升,都显著导致了孕产妇发病率和死亡率的增加。本章重点关注重症监护在降低孕产妇死亡率和发病率方面的作用。