基于Robson分类的瘢痕子宫剖宫产率变化及其产妇特征分析

Changes of cesarean section rate and maternal characteristics of scar uterus based on Robson classification

目的:探究基于Robson分类的瘢痕子宫剖宫产率变化及其产妇特征。方法:选择2017年2月1日-2019年11月30日在深圳市南山区蛇口人民医院及深圳市妇幼保健院分娩的6222例瘢痕子宫产妇,按Robson分类标准进行分组,并通过对比各组剖宫产情况,分析瘢痕子宫剖宫产率变化。结果:按Robson分组看,6222例瘢痕子宫产妇以5组(3034例,48.76%)和10组(2153例,34.60%)为主;其中有4617例选择剖宫产,总剖宫产率为74.20%,5组占44.68%,10组占15.11%,各组剖宫产率均高于自然分娩率(P<0.05);7组的组内剖宫产率(98.14%)最高,10组(43.66%)最低。2017年-2019年,瘢痕子宫产妇剖宫产率逐年上升(P<0.05)。2017-2019年瘢痕子宫产妇分娩的新生儿性别比(男/女)波动范围在110~129∶100间,按Robson分组看,5组和10组的男婴比例较高。2017-2019年瘢痕子宫产妇的文化程度以中专及高中居多,且大专及以上学历呈上升趋势(P<0.05)。2017-2019年瘢痕子宫产妇参与孕妇学校健康管理培训的比例逐年增高,且与自然分娩率呈高度正相关(r=0.9892)。结论:2017-2019年瘢痕子宫产妇的剖宫产率呈上升趋势;通过Robson分类可以有效监测瘢痕子宫产妇剖宫产率变化;医院要想降低瘢痕子宫产妇剖宫产率需加强健康管理培训,做好孕产妇及其家属的健康宣教,积极鼓励单胎头位胎儿进行自然分娩,并同时重点关注和提高早产儿生存率。

Objective:To explore the change of cesarean section rate and maternal characteristics of scar uterus based on Robson classification.Methods:6222 women with scar uterus who gave birth in our hospital and Shenzhen Maternal and Child Health Care Hospital from February 1,2017 to November 30,2019 were selected and grouped according to Robson classification standard.The cesarean section rate of scar uterus was analyzed by comparing the cesarean section rate of each group.Results:According to Robson group,the 6222 cases of women with scar uterus were mainly in 5 groups(3034 cases,48.76%)and 10 groups(2153 cases,34.60%).There were 4,617 cesarean sections selected,with a total cesarean section rate of 74.20%,44.68%in 5 groups and 15.11%in 10 groups.The cesarean section rate in each group was higher than that of natural delivery(P<0.05).The cesarean section rate(98.14%)was the highest in group 7,and the lowest in group 10(43.66%).From 2017 to 2019,cesarean section rate of women with scar uterus increased year by year(P<0.05).From 2017 to 2019,the sex ratio(male/female)of newborns with scar uteri mothers fluctuated between 110 and 129∶100.According to Robson’s grouping,male babies in group 5 and group 10 were relatively high.(5)From 2017 to 2019,technical secondary school and high school were the most common educational backgrounds of women with scar uterus,and college degree or above presented an increasing trend(P<0.05).(6)From 2017 to 2019,the proportion of women with scar uterus participating in health management training in schools for pregnant women increased year by year,and was positively correlated with the rate of natural delivery.Conclusion:From 2017 to 2019,the cesarean section rate of pregnant women with scar uterus showed an increasing trend.Robson classification can effectively monitor the variation of cesarean section rate of pregnant women with scar uterus.In order to reduce the cesarean section rate of pregnant women with scar uterus;In order to reduce the cesarean section rate of pregnant women with scar uterus,hospitals need to strengthen the training of health management for pregnant women,do a good job of health education for pregnant women and their families,actively encourage the natural delivery of single head fetus,and pay attention to and improve the survival rate of premature infants at the same time.