Gulumser Cagri, Engin-Ustun Yaprak, Keskin Levent, Celen Sevki, Sanisoglu Sema, Karaahmetoglu Selma, Ozcan Ayse, Sencan Irfan
Department of Obstetrics and Gynecology, University of Health and Science , Istanbul , Turkey.
General Directorate of Mother and Child Health and Family Planning, Ministry of Health of Turkey , Ankara , Turkey.
J Matern Fetal Neonatal Med. 2019 Dec;32(23):3998-4004. doi: 10.1080/14767058.2018.1481029. Epub 2018 Jun 11.
The aim of this study was to determine the epidemiological characteristics of maternal mortality due to postpartum hemorrhage, and to investigate whether national preventative measures of the Maternal Mortality Program have been successful in Turkey. A population-based cohort study. Turkish National Maternal Mortality Data collected by the Turkish Ministry of Health. Women who died due to hemorrhage during pregnancy or after delivery within the initial 42 days, from 2012 to 2015, throughout Turkey ( = 812/146). The preventability and problems in each maternal death due to hemorrhage. A total of 779 maternal deaths were identified during the study period. Our estimate of the Maternal Mortality Ratio (MMR) in the 3-year period was 19.7 per 100,000 live births. Of the 779 deaths, the report listed 411 as direct and 285 as indirect deaths. Direct obstetric complications were the leading causes of maternal deaths, the most common of which was maternal cardiovascular diseases (21%) and obstetric hemorrhage (20.6%). Improving data surveillance and implementing national guidelines for the prevention and management of major complications of pregnancy, childbirth, and puerperium is necessary to reduce MMR. The healthcare authorities of Turkey should continue to set a sustainable development goal of ≤70 maternal deaths per 100,000 live births by 2030. We believe our results may provide useful information for other developing countries that are aiming to reduce maternal mortality, as well as mobilize global efforts to improve women's health.
本研究的目的是确定产后出血导致孕产妇死亡的流行病学特征，并调查土耳其孕产妇死亡项目的国家预防措施是否成功。一项基于人群的队列研究。由土耳其卫生部收集的土耳其国家孕产妇死亡数据。2012年至2015年期间，在土耳其全境，在怀孕或分娩后最初42天内因出血死亡的妇女（n = 812/146）。每例因出血导致的孕产妇死亡的可预防性及问题。在研究期间共确定了779例孕产妇死亡。我们估计这3年期间的孕产妇死亡率（MMR）为每10万例活产19.7例。在这779例死亡中，报告列出411例为直接死亡，285例为间接死亡。直接产科并发症是孕产妇死亡的主要原因，其中最常见的是孕产妇心血管疾病（21%）和产科出血（20.6%）。改善数据监测并实施关于妊娠、分娩和产褥期主要并发症预防和管理的国家指南对于降低孕产妇死亡率是必要的。土耳其卫生当局应继续设定到2030年每10万例活产孕产妇死亡≤70例的可持续发展目标。我们相信我们的结果可能为其他旨在降低孕产妇死亡率的发展中国家提供有用信息，同时也能动员全球努力改善妇女健康。
