Objective To understand the epidemiological status of critically ill obstetric patients in Dongguan City and analyze the risk factors of dead cases, in order to provide scientific evidences to set up further preventive strategy for decreasing the rate of maternal mortality. Methods A retrospective analysis of cases of critically ill obstetric admitted to Dongguan People's Hospital and Dongguan Maternal and Child Health Hospital from September 1st 2009 to August 31st 2013 was made. Data included numbers of pregnant and lying-in women and critically ill obstetric patients, ob-stetric emergencies and complications;demographic of dead patients, regular antenatal care, the time intervals between onset of acute symptoms and ICU admission, blood purification and the acute physiology and chronic health evaluationII(APACHE II) score. The epidemiological and clinical characteristics of critically ill obstetric patients and deaths in Dongguan were retrospectively analyzed. Results During the 5-year period there were upward trend on cases of critical-ly ill obstetric patients, and the prevalence rate of critically ill obstetric patients was 8.99%-9.28%. The most common obstetric causes of admission were massive postpartum haemorrhage (63.54%), followed by pregnancy-associated hyper-tension (15.85%) and placenta previa (8.92%). The most common non-obstetric causes of admission were acute heart failure (1.98%). During the 5-year period, 20 critically ill obstetric patients died in two hospitals, mortality rate was 0.24% (20/8129). The mean age of dead women was (30.3±6.6) years old and mean gestational age was (30.1±9.3) weeks. There were more parity (parity>2, 75%), lower educational level (≤junior level, 90%), more outsiders (85%) and lower regular antenatal care rate (15%) on dead cases. The most common cause of death were pregnancy-associated hypertension, acute heart failure and massive postpartum haemorrhage. The dead cases had longer interval between onset of acute symptoms and ICU ad-mission (media=62.5 h), higher APACHEIIscore [(25.4±5.4) scores] and lower blood purification treatment rate (10%). Conclusion The incidence of critically ill obstetric patients is high in Dongguan City. There are more parity, lower edu-cational level, more outsiders, lower regular antenatal care rate and longer interval between onset of acute symptoms and ICU admission on dead women. Critically ill obstetric patients may benefit from enhancing publicity and education, offering health care by government, prevention of critical obstetric and medical complications,shortening the interval between onset of acute symptoms and ICU admission and strengthening the support of organ function.%目的：分析东莞市危重孕产妇的流行病学及临床特征,为东莞市制订降低危重孕产妇病死率的干预措施提供科学依据。方法收集2009年9月1日~2013年8月31日东莞市人民医院和东莞市妇幼保健院收治的危重孕产妇及死亡病例的统计数据和临床资料,包括产妇和危重孕产妇的病例数、危重孕产妇常见产科合并症和并发症；死亡孕产妇的基本特征、是否进行规律产前检查、发病至转入ICU时间、血液净化治疗及APACHEⅡ评分等指标。回顾性分析东莞市危重症孕产妇及死亡病例的流行病学及临床特征。结果5年内两家医院收治危重孕产妇的例数和比例有上升趋势,危重孕产妇患病率为8.99%~9.28%；东莞市危重孕产妇最多见的并发症是产后出血(63.54%),其次为妊娠高血压综合征(15.85%)、前置胎盘(8.92%),最常见的内科合并症是心脏病(1.98%)。5年内两院死亡孕产妇20例,病死率为0.24%(20/8129),病死孕产妇平均年龄为(30.3±6.6)岁,平均孕龄为(30.1±9.3)周,孕次>2次的占75%,初中及初中以下文化程度占90%,大部分为外地户籍孕产妇(85%),规律产前检查率不足15%。常见死因为妊娠高血压综合征、心脏病和产后出血,发病至转入ICU中位数时间为62.5 h,转入时平均APACHEⅡ评分为(25.4±5.4)分,血液净化治疗患者仅占10%。结论东莞市危重孕产妇患者数较多,死亡孕产妇存在孕次多、文化程度低、外地户籍、孕前规律产检率低、转入ICU时间延迟等特点。对孕产妇进行宣传教育、提供医疗保障、及时处理并发症和合并症、及时转送ICU并在ICU内加强各器官功能支持可能有助于降低危重症孕产妇的病死率。
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