고위험 산모 응급이송시스템 구축 필요성 및 향후 계획

Abstract

The total fertility rate in South Korea is one of the lowest among the Organisation for Economic Co-operation and Development (OECD) countries. However, the number of advanced maternal age and high risk pregnancies are rising due to delays in marriage and increased infertility rates, resulting in a maternal mortality rate that is higher than the OECD average. The most common cause of maternal mortality has been reported to be obstetric embolism, followed by postpartum hemorrhage. Hemorrhage is a preventable condition that can be solved by expeditious initial management such as transfusion, medication, and prompt transfers to tertiary centers that are capable of managing obstetric emergencies. However, the number of maternity care hospitals in underserved areas has been falling since 2004 due to business losses stemming from low birth rates, inadequate insurance payments for obstetric services, and the shortage of obstetricians. The insufficient maternity care system for high risk pregnant women in Korea has also led to an increase in maternal mortality. Therefore, the Ministry of Health and Welfare has supported the establishment of an ‘Integrated Care Center for High Risk Pregnancy and Neonate’ for high risk maternity and neonatal cases. However, there is no systematic transfer system in place to monitor and support emergency patient transfers in the event of obstetric emergencies. Although the Disaster & Emergency Medical Operations Center is currently carrying out these tasks, it is insufficient to properly manage all obstetric transfers. Our plan is to establish an Emergency Maternal Transport Control Center that is linked with the existing Disaster & Emergency Medical Operations Center at the National Medical Center. To implement this system, cooperation from each maternity and neonatal center will be crucial to share available human and material resources. Successful implementation of this system will allow for communication not only with the regional perinatal centers, but on a nationwide scale to detect and conduct necessary transfers of high risk pregnancy patients in emergency situations. It is anticipated that this system will significantly improve maternal health care as well as obstetric infrastructure, especially in underserved areas.