Analysis Of Death Cases Of Hypertensive Disorders During Pregnancy In The Last 4 Years Of Jilin Province

Objective:In recent years,the maternal mortality rate of Jilin Province decreased significantly,mainly as a reduction in obstetric hemorrhage deaths,but the number of pregnant women die of gestational hypertension is increasing every year. In these cases of hypertensive disorders in pregnancy,the majority are severe pre-eclampsia. Based on four years of Jilin Province gestational hypertension in pregnancy deaths retrospectively reviewed to understand the characteristics of these cases,lessons learned,with a view to enhance perinatal care and the clinical importance of these patients to reduce the disease rate and improve the treatment success rate.Materials and Methods:Retrospective analysis of maternal deaths cases due to gestational hypertension of Jilin Province from 2006 to 2009,according to the region reported data,according to various regions of the reported data,every case of death general information,prenatal care,disease through clinical diagnosis and treatment,and death related information for statistics and analysis.Result:After provincial expert assessments,42 cases are included of maternal mortality due to gestational hypertension. These puerperal age are between 18 and 43 years old,of which less than 20 years old are 2 cases,the proportion of 4.76%; 20 to 24 years old are 8 cases,the proportion of 19.05%; 25 to 29 years old are 11 cases,the proportion of 26.19%; 30 to 34 years old are 8 cases,the proportion of 19.05%; Compared with the provincial average economic level, the number of general economic conditions is16 cases,the number of poor economic conditions is 18cases,the number of better economic conditions is only 8 cases. The total planned pregnancy is 34 cases and unwanted pregnancies are 8 cases. In 42 cases,38 cases carried out prenatal care,which only 12 cases have more than 5 times prenatal care; 2 cases do not carry out prenatal care (both unplanned pregnancy). 4 cases of records are unknown. 20 cases disease in the third trimester (≥34 weeks),there are 15 cases when the disease is less than 32 weeks,7 patients when the disease is less than 34 weeks. In 42 patients,only 9 patients for referral,the other remaining 34 cases are not referred. In 42 patients,left heart failure in 9 cases,cerebral hemorrhage with cerebral hernia in 11 cases,the HELLP syndrome in 6 cases,placental abruption occurred in 5 cases,venous sinus thrombosis in 3 cases,liver failure in 3 cases,postpartum hemorrhage in 3 cases,hernia in 2 cases,cerebral infarction in 1 case,multiple organ failure in 1 case. Except for one prognosis record of a perinatal infant is unknown,19 cases of stillbirth,neonatal deaths in 3 cases,neonatal survival in 18 patients. In 42 patients,16 patients did not give birth died,17 patients died within 3 days postpartum,in which 11 died within 1 day postpartum; 9 patients died between 4 days to 23 days post-natal. 9 puerperal in childbirth died after 4 days to 23 days. Of death recorded in 39 patients,35 cases could be avoided death,4 cases of inevitable death.Conclusion:1. After 42 cases of pregnancy induced hypertension cases of maternal death analysis, found that these patients occurred while hypertensive disorders in pregnancy are associated with serious complications. To reduce the maternal mortality rate, the main way is to reduce the complications of hypertensive disorders complicating pregnancy(HDCP). 2. The gestational hypertension is preventable and curable diseases specific to pregnancy,health education,particularly to strengthen the rural pregnant women,migrants,low educational level,income and poor target population perinatal care,pregnancy should be a comprehensive system of early care and high-risk screening. When the 42 cases of maternal deaths to the hospital for treatment, they have serious complications, which lead to disease progression, delay in treatment. Early detection,early diagnosis and early treatment to avoid complications is important to reduce the incidence of HDCP.3. Etiology and pathogenesis of early onset of severe preeclampsia is not single,but complex. On the basis of a comprehensive assessment,it should be select a reasonable and appropriate treatment for the pregnant women and fetuses, timely terminate the pregnancy. If the pregnant women themselves or their families look forward to strong demand treatment,should be in selected tertiary hospitals,and base on the maternal-fetal status a multi-disciplinary consultation should be organized.