ABSTRACT
Objective@#To analyze the risk factors of high-risk pregnancy, the change factor conversion rate and pregnancy outcomes, summarize the experience of high-risk pregnancy management, make it rationalized and standardized, improve the health of pregnant women and perinatal children, and guarantee the safety of mother and baby.@*Methods@#The 6 472 pregnant women who were admitted to the hospital from January 2016 to March 2017 were screened for high-risk factors according to the relevant management methods and implementation rules of high-risk pregnancies, and systematic management of high-risk pregnant women was conducted.@*Results@#Among 6 472 pregnant women, 1 610 pregnant women were high-risk pregnancies, and the incidence rate was 24.88%. Three or more high-risk factors accounted for 163 cases (10.12%), two high risk factors accounted for 391 (24.29%) , one risk factors accounted for 1056 cases (65.59%). The top five risk factors were abortion history, age, gestationathe or mild pre-eclampsia, preterm prematurity, and premature rupture of fetal membranes at more than 34 weeks. Among pregnant women with high risk, 249 cases (11.29%) were between 19 and 25 years old; 441 cases (18.27%) of 26-30 years old; 536 cases (36.49%) of 31-34 years old; 384 cases (100.00%) of the 35-year old. The incidence of high-risk pregnancy was closely related to age, and the incidence of high-risk pregnancy was 100% in patients over 35 years old, with the increase of age. The risk factors of hypertension, preterm birth, endocrine disease and prenatal hemorrhage could be change normal rates were 32.77% (58/177), 83.21% (109/131), 46.88% (45/96) and 83.13% (69/83) respectively. The age group with the highest cesarean section rate was ≥35 years old. The c-section rate gradually decreased with age. The age group with the highest vaginal assist rate was 31-34 years old high-risk pregnant women without obviously differences between groups; the highest perinatal mortality rate was ≥35 years old (P <0.05). The risk of eclampsia, puerperal infection and postpartum hemorrhage was significantly higher in maternal ≥35 years old than in other age groups (P <0.05).@*Conclusions@#There are many influencing factors of high risk pregnancy, screening, identification and management of the influence factors, attention to health education, to promote the hospital management and community management cooperation, strengthen the management of high-risk pregnancies, helps to reduce the risk of maternal severe adverse pregnancy outcomes, and improve maternal and infant prognosis.
ABSTRACT
Objective To analyze the risk factors of high-risk pregnancy, the change factor conversion rate and pregnancy outcomes, summarize the experience of high-risk pregnancy management, make it rationalized and standardized, improve the health of pregnant women and perinatal children, and guarantee the safety of mother and baby. Methods The 6 472 pregnant women who were admitted to the hospital from January 2016 to March 2017 were screened for high-risk factors according to the relevant management methods and implementation rules of high-risk pregnancies, and systematic management of high-risk pregnant women was conducted. Results Among 6 472 pregnant women, 1 610 pregnant women were high-risk pregnancies, and the incidence rate was 24.88%. Three or more high-risk factors accounted for 163 cases (10.12% ), two high risk factors accounted for 391(24.29%), one risk factors accounted for 1056 cases (65.59%). The top five risk factors were abortion history, age, gestationathe or mild pre-eclampsia, preterm prematurity, and premature rupture of fetal membranes at more than 34 weeks. Among pregnant women with high risk, 249 cases (11.29%) were between 19 and 25 years old; 441 cases (18.27%) of 26-30 years old; 536 cases (36.49%) of 31-34 years old; 384 cases (100.00%) of the 35-year old. The incidence of high-risk pregnancy was closely related to age, and the incidence of high-risk pregnancy was 100% in patients over 35 years old, with the increase of age. The risk factors of hypertension, preterm birth, endocrine disease and prenatal hemorrhage could be change normal rates were 32.77% (58/177), 83.21% (109/131), 46.88% (45/96) and 83.13% (69/83) respectively. The age group with the highest cesarean section rate was ≥35 years old. The c-section rate gradually decreased with age. The age group with the highest vaginal assist rate was 31-34 years old high-risk pregnant women without obviously differences between groups; the highest perinatal mortality rate was≥35 years old (P<0.05). The risk of eclampsia, puerperal infection and postpartum hemorrhage was significantly higher in maternal ≥35 years old than in other age groups (P <0.05). Conclusions There are many influencing factors of high risk pregnancy, screening, identification and management of the influence factors, attention to health education, to promote the hospital management and community management cooperation, strengthen the management of high-risk pregnancies, helps to reduce the risk of maternal severe adverse pregnancy outcomes, and improve maternal and infant prognosis.
ABSTRACT
Objective:To investigate the effects of sign-contract services on hypertension patient disease control and the satisfaction of medical staff. Methods:a face-to-face questionnaire survey was conducted among hypertension patients selected from 20 primary health centers in 10 provinces in China. Results:This paper collected 1 ,881 valid questionnaires, and the average age of the population was 65. 72 ± 10. 88. Respondents that received sign-contract services accounted for 53. 88%, and there was no difference between patients who signed the service contract and who did not in terms of demographics. In self-reporting of blood pressure controls, respondents who signed the service contract, aged 40~50 years old, enjoyed the free medical care, preferred to seek medical services from primary a-gencies ( i. e. community health centers and township hospitals) for minor illnesses, controlled their blood pressure better ( P<0. 05 ) . Respondents enjoyed the civil resident medical insurance, preferred to seek medical care from community health centers for minor illnesses and signed the service contract were more likely to be satisfied with their medical practitioner (P<0. 05). After adjusting for age, gender, education level, medical insurance style, patient willingness to seek medical care for minor illnesses, signing service contracts was found to be an independent factor both associated with blood pressure self-control and attitudes towards medical service providers, with the odds ratio of 3. 007 (95%CI:2. 572 -3. 517) and 1. 814 (95%CI: 1. 563 -2. 105) respectively. Conclusion: Contracts are correlated with blood pressure control and satisfaction toward medical practitioners, which means that patients who signed the service contract control their blood pressure better and are more satisfied with their medical deliverers.