Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan.
Department of Obstetrics and Gynecology, Sakakibara Heart Institute, Tokyo, Japan.
Sci Rep. 2019 Jul 30;9(1):11026. doi: 10.1038/s41598-019-47378-z.
This descriptive study was based on the maternal death registration system established by the Japan Association of Obstetricians and Gynecologists and the Maternal Death Exploratory Committee (JMDEC). 361 women died during pregnancy or within 42 days after delivery between January 2010 and June 2017 throughout Japan were analysed, in order to investigate the trend in maternal deaths related to obstetric medical practice. Reports of maternal death were consistent, ranging from 45 cases in 2010 to 44 cases in 2017. Among all maternal deaths, the frequency of deaths due to obstetric haemorrhage ranged from 29% (2010) to 7% (2017) (p < 0.001). The causes of obstetric haemorrhage have progressively reduced, especially maternal deaths due to uterine inversion and laceration have not occurred since 2014. The remaining causes of obstetric haemorrhage-related maternal deaths were placenta accreta spectrum, placental abruption, and severe forms of uterine focused amniotic fluid embolism. We believe the activities of the JMDEC including annual recommendations and simulation programs are improving the medical practices of obstetric care providers in Japan, resulting in a reduction of maternal deaths due to obstetric haemorrhage.
本描述性研究基于日本妇产科医师会（JOA）和孕产妇死亡探索委员会（JMDEC）建立的孕产妇死亡登记系统。分析了 2010 年 1 月至 2017 年 6 月期间日本全国范围内 361 名在妊娠期间或分娩后 42 天内死亡的妇女，以调查与产科医疗实践相关的孕产妇死亡趋势。孕产妇死亡报告数量一致，从 2010 年的 45 例到 2017 年的 44 例。在所有孕产妇死亡中，因产科出血导致的死亡频率从 2010 年的 29%（45 例）降至 2017 年的 7%（31 例）（p<0.001）。产科出血的原因逐渐减少，特别是自 2014 年以来，子宫内翻和撕裂导致的孕产妇死亡已不再发生。产科出血相关孕产妇死亡的其余原因是胎盘植入谱系疾病、胎盘早剥和严重形式的子宫羊水栓塞。我们认为，JMDEC 的活动，包括年度建议和模拟计划，正在改善日本产科医务人员的医疗实践，从而减少因产科出血导致的孕产妇死亡。
