OBJECTIVETo analysis the trend of maternal death time and explore the impact of the variety of death causes and birth place to maternal death time.

METHODSAccording to the data provided by Beijing Maternal and Children Health Hospital, the 372 death cases of pregnant and lying-in women from 1995 to 2010, a retrospective study was performed to analyze the death causes, maternal death time and the influencing factors.

RESULTSThe MMR declined from 27.9 per 100 000 live births from 1995 to 2000 to 14.8 per 100 000 live births from 2006 to 2010, with a decline of 46.9%. Among the maternal death within 24 hours of delivery, 79.7% (106/133) died of obstetric hemorrhage, hypertensive disorder complicating pregnancy and amniotic fluid embolism. It took up 47.8% (64/134) from 1995 to 2000, reduced to 37.5% (45/120) from 2006 to 2010. At the same time, the maternal mortality ratio within 24 hours reduced from 40.2%(54/134) to 28.3% (34/120), the variation of death time was consistent with the causes of maternal mortality (χ² = 59.109, P < 0.05). Indirect obstetric causes increased significantly from 2006 to 2010, 53.2% (33/62) of pregnant women with heart disease, cerebrovascular disease and pulmonary embolism died in prenatal or more than 120 hours postnatal. Among the maternal death delved in hospital, 29.0% (29/100) died within 24 hours, 52 cases delved at home or in private clinics, 43 cases (82.6%) died within 24 h postnatal. There were significant differences between birth place and death time (χ² = 24.500, P < 0.05).

CONCLUSIONMaternal death time changed from 24 hours of delivery to prenatal or postnatal a long time. The maternal mortality causes and hospital delivery is an important factor affecting maternal time.

Cause of Death ; China ; Female ; Humans ; Maternal Health Services ; Maternal Mortality ; trends ; Pregnancy ; Pregnancy Complications ; mortality

OBJECTIVETo analyze time trend and regional disparities in maternal mortality ratio (MMR) and major causes of maternal death in China from 1996 to 2010.

METHODSData used in this study were based on national maternal mortality surveillance system. From 1996 to 2005, it included 176 monitoring districts (countries) in 31 provinces, autonomous regions and municipalities in the inner land. From 2006 to the present, it covered 336 districts (countries). MMR, major causes of maternal death and their reduction margin, average annual reduction rate in different times and regions from 1996 to 2010 were analyzed. The trend and regional differences in MMRs and major causes of mortality were analyzed using Cochran-Armitage trend and Poisson Test.

RESULTSFrom 1996 to 2010, Chinese MMR has decreased by 53.2% from 64.7 in 1996 to 30.0 per 100 000 live births in 2010. MMR was higher in rural areas (30.1/100 000) than in urban areas (29.7/100 000), and highest in the west region (46.1/100 000) followed by the middle region (29.1/100 000) and the east region (17.8/100 000) in 2010. MMR in east, middle and west regions have decreased by 37.76%, 57.02% and 66.27% respectively from 1996 to 2010. The disparities between different regions were decreasing. From 2006 to 2010, MMR in rural areas has dropped to 1.82 times of the city, and that in the west was 3 times of the east. Obstetric hemorrhage was still the leading cause of maternal death, responsible for 47.9% maternal deaths in 1996 and 27.8% in 2010. The risk of death due to obstetric hemorrhage was decreasing.

CONCLUSIONThe MMR in China showed the decreasing trends. Although the regional disparities were still remarkable, they demonstrated narrowing trends. Interventions on maternal death should be focused in rural areas and west regions.

China ; Female ; Humans ; Maternal Mortality ; trends ; Population Surveillance ; Pregnancy ; Pregnancy Complications ; mortality

Adult ; Female ; Hepatitis ; complications ; diagnostic imaging ; mortality ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; diagnostic imaging ; mortality ; Prognosis ; Ultrasonography

OBJECTIVETo analyze the maternal mortality ratio (MMR) of residential and migrant women in Beijing.

METHODSA retrospective study from 1995 to 2004 was performed to analyze data from the maternal death cases.

RESULTSThe MMR of resident and migrant of Beijing from 1995 to 2004 were 17.9 and 51.3 per ten thousand respectively. The main reasons of maternal deaths among residents were embolism (21.2%), hypertensive disorder complicating pregnancy (18.3%), postpartum hemorrhage (14.4%) and ectopic pregnancy/heart disease (9.6%). The main reasons of migrant maternal deaths were postpartum hemorrhage (25.2%), embolism (19.7%), hypertensive disorder complicating pregnancy (17.3%) and liver disease (9.5%). The avoidable deaths were accounted for 18.9%.

CONCLUSIONThe MMR in Beijing local residents was close to that in developed countries. To further reduce MMR in Beijing would depend on the better administration of related issues among floating population. Poor quatily delivery must be banned together with strengthening the training programs on health workers. It is also important to improve the knowledge and skills of medical staff for rescuing the complications of pregnancy and ectopic pregnancy.

China ; epidemiology ; Female ; Humans ; Liver Diseases ; mortality ; Maternal Health Services ; Maternal Mortality ; Postpartum Hemorrhage ; mortality ; Pregnancy ; Pregnancy Complications ; mortality ; Pregnancy Complications, Cardiovascular ; mortality ; Retrospective Studies ; Transients and Migrants ; statistics & numerical data

OBJECTIVETo explore the factors associated with perinatal death of hepatic diseases in pregnancy (HDIP) and make feasible suggestions and measures for perinatal care of high risk patients.

METHODSThe 80 perinatal death cases of hepatic diseases in pregnancy (HDIP) during 1991-2000 in our hospital were analyzed retrospectively.

RESULTSThe perinatal mortality of HDIP in our hospital during the last 10 years was 17.99 approximately 65% was in utero death. Perinatal mortality was different between male (21.64%) and female (10.11%) (P<0.01). Compared first 5 years with last 5 years author found that the perinatal mortality of HDIP had no significant decrease (P>0.05). The perinatal mortality in city and suburbs had decreased, while in the floating population from other provinces the perinatal mortality had increased. The perinatal death was mainly caused by pregnancy induced hypertension (PIH) and asphyxia. But for the HBV carrier mothers the causes of death included umbilical cord problems, premature rupture of membrane and asphyxia.

CONCLUSIONSThe perinatal death mortality was increased by HDIP, deaths were essentially associated with pregnancy induced hypertension and asphyxia and the floating population and male gender were high risks. To enhance the management of HDIP or immigration, take effective therapies of hepatitis and improvement of resuscitation of newborns are critically important.

Adolescent ; Adult ; Cause of Death ; Female ; Fetal Death ; epidemiology ; Fetal Distress ; etiology ; mortality ; Humans ; Infant Mortality ; Infant, Newborn ; Liver Diseases ; complications ; mortality ; Male ; Pre-Eclampsia ; complications ; mortality ; Pregnancy ; Pregnancy Complications ; mortality ; Retrospective Studies ; Sex Factors

Pregnancy in patients with Eisenmenger syndrome (ES) is associated with high maternal mortality rates of 30%‒50%, or even up to 65% in the case of a cesarean section (Yuan, 2016). Here, we report a case of term pregnancy complicated with ES and severe pulmonary artery hypertension (PAH), which was managed by a multidisciplinary team (MDT) and resulted in an uncomplicated delivery via elective cesarean section. The goal of this study is to emphasize the importance of multidisciplinary approach in the management of pregnancy with ES, which can profoundly improve maternal and infant outcomes.
Female ; Humans ; Pregnancy ; Cesarean Section ; Eisenmenger Complex/therapy* ; Hypertension, Pulmonary/therapy* ; Maternal Mortality ; Pregnancy Complications, Cardiovascular/therapy* ; Pregnancy Outcome

Adult ; Cardiology ; methods ; Cardiomyopathy, Dilated ; diagnosis ; mortality ; Female ; Humans ; Obstetrics ; methods ; Peripartum Period ; Pregnancy ; Pregnancy Complications, Cardiovascular ; diagnosis ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Puerperal Disorders ; diagnosis ; mortality ; Risk Factors ; Ventricular Dysfunction, Left ; diagnosis ; mortality

OBJECTIVETo explore the clinical manifestations and short-term prognosis of twin-twin transfusion syndrome (TTTS) in neonates with different disease stages, receiving different intrauterine interventions, or as blood donors and recipients.

METHODSThe study retrospectively collected 76 TTTS neonates who were hospitalized in the Neonatal Ward, Peking University Third Hospital. The participants were classified into mild TTTS (n=38) and severe TTTS groups (n=21), or into amnioreduction (n=20), laser surgery (n=21), and expectant therapy groups (n=32), or into donor (n=23) and recipient groups (n=30).

RESULTSThe severe TTTS group had higher incidences of brain injury, heart disease, asphyxia, and renal damage and in-hospital mortality rate compared with the mild TTTS group, but the differences had no statistical significance. The laser surgery group displayed decreasing trends in the incidences of brain injury, heart disease, and renal damage and in-hospital mortality rate compared with the amnioreduction and expectant therapy groups. The recipient group had higher incidences of heart diseases and pathological jaundice than the donor group (P<0.05). The donor group had higher incidences of asphyxia and renal damage than the recipient group, but with no significant difference.

CONCLUSIONSThe neonates with severe TTTS have higher rates of organ damages and in-hospital mortality. Intrauterine laser surgery seems to lead to a better prognosis compared with the amnioreduction and expectant therapy. The recipients are more susceptible to heart diseases and pathological jaundice, whereas the donors are more susceptible to asphyxia and renal damage.

Female ; Fetofetal Transfusion ; complications ; mortality ; surgery ; Humans ; Infant, Newborn ; Laser Therapy ; Pregnancy ; Prognosis ; Retrospective Studies

OBJECTIVETo investigate the factors related to maternal mortality rate in 1000 counties of projects on reducing maternal mortality rate (MMR) and eliminating tetanus neonates in China, 2003.

METHODSStudy on the association was performed using data on average income per capita, hospital delivery rate and MMR.

RESULTSData showed that income per capita and hospital delivery rate had strong association with MMR. MMR for women with income less than 1000 Chinese Yuan per capita was 100.9 per 100 000 live births, and with income over 2000 Yuan per capita was 61.8 per 100 000 live births. MMR was 107.2 per 100 000 live births for women with hospital delivery rate less than 50%, and 54.1 per 100 000 live births with hospital delivery rate over 75%. The hospital delivery rate was less than 50% in the counties with income less than 1000 Yuan per capita, and over 75% with income over 2000 Yuan per capita. Only 19.1% of the counties with income less than 1000 Yuan per capita and 66.7% over 2000 Yuan per capita reached 75% hospital delivery rate.

CONCLUSIONMMR and hospital delivery rate were affected by economic level of individuals. MMR seemed inversely proportional to income per capita and hospital delivery rate. The hospital delivery rate in 1000 counties was closely associated with income per capita. MMR could be reduced by enhancing hospital delivery rate.

China ; epidemiology ; Delivery, Obstetric ; statistics & numerical data ; Female ; Humans ; Income ; statistics & numerical data ; Maternal Health Services ; Maternal Mortality ; Pregnancy ; Pregnancy Complications ; mortality ; Socioeconomic Factors

BACKGROUNDEarly onset severe preeclampsia is a specific type of severe preeclampsia, which causes high morbidity and mortality of both mothers and fetus. This study aimed to investigate the clinical definition, features, treatment, outcome and risk factors of early onset severe preeclampsia in Chinese women.

METHODSFour hundred and thirteen women with severe preeclampsia from June 2006 to June 2009 were divided into three groups according to the gestational age at the onset of preeclampsia as follows: group A (less than 32 weeks, 73 cases), group B (between 32 and 34 weeks, 71 cases), and group C (greater than 34 weeks, 269 cases). The demographic characteristics of the subjects, complications, delivery modes and outcome of pregnancy were analyzed retrospectively.

RESULTSThe systolic blood pressure at admission and the incidence of severe complications were significantly lower in group C than those in groups A and B, prolonged gestational weeks and days of hospitalization were significantly shorter in group C than those in groups A and B. Liver and kidney dysfunction, pleural and peritoneal effusion, placental abruption and postpartum hemorrhage were more likely to occur in group A compared with the other two groups. Twenty-four-hour urine protein levels at admission, intrauterine fetal death and days of hospitalization were risk factors that affected complications of severe preeclampsia. Gestational week at admission and delivery week were also risk factors that affected perinatal outcome.

CONCLUSIONSEarly onset severe preeclampsia should be defined as occurring before 34 weeks, and it is featured by more maternal complications and a worse perinatal prognosis compared with that defined as occurring after 34 weeks. Independent risk factors should be used to tailor the optimized individual treatment plan, to balance both maternal and neonatal safety.

Adult ; Cardiovascular Diseases ; epidemiology ; etiology ; Female ; Fetal Death ; Gestational Age ; Humans ; Pre-Eclampsia ; epidemiology ; mortality ; Pregnancy ; Pregnancy Complications ; epidemiology ; mortality ; Risk Factors