剖宫产率与围产儿死亡率的关系

ENGLISH ABSTRACTS OF ORIGINAL ARTICLESRelationslup betweeu cesarean sectiou rate andperinatabmortality rate

对北京妇产医院１９８０年１月１至１９９２年１２月３１日行剖宫产术的孕妇１１８５５７例及同期围产儿死亡１１４０例进行回顾性分析。结果表明：在此期间平均剖宫产率为２５．０％，平均围产儿死亡率为１５．２‰。向１９８５年起剖宫产率明显升高，但围产儿死亡率并未相的下降。剖宫产分娩的早期新生儿死亡高于阴道分娩。提示：提高剖宫产率并不一定能使围产儿死亡率降低。

n order to evaluate the effect of cesarean sectionon reduction of perinatal mortality rate (PMR). Allcases delivered in Beijing Obstetrics and GynecologyHospital from Jan. 1, 1980 to Dec. 31 , 1992 were ana-lysed. The total number of delivery in study periodwas 74 199. Number of cesarean section delivery was18 557. The cesarean section rate was 25.0 % . The totalnumber of perinatal baby was 74 914. The number ofporinatal death was 1 140. PMR was 15.20‰ . The 13years were divided into three periods to compare thecesarean section rate and PMR. The lst period wasfrom 1980 to 1984. The 2nd period was from 1985 to1988. Years from 1989 to 1992 were 3rd perioed Theeesarean section rate was increasing year by year. Itwas significant since 1985. On the other hand, thePMR was marked decreasing since 1983. But therewas no continually decrease in Znd period. In 3rd Period trend of decreasing PMR was shown. Tbere wasno significant difference in PMR especially in neonatalmortality rate (NMR) between cesarean section groupand vaginal delivery group in lst period. In 2nd periodthe PMR and NMR of eesarean section group washigher than that of vaginal delivery group (P< 0.01).In 3rd period it was lower in cesarean section group(P < 0.05). Main causes of neonatal deaths in cesareansection group were congenital abnornialities andrespiratory diseases. In Znd period pulmonaryhemoirhage, hyaline membrane disease were markedhigher in eesa.ean section group. It was related tomore premature and low birth weight babies in thisgroup. In 3rd period it was paid attention to improvematurity of fetal lung and to prevent neonatalasphyxia. It resulted in reduction of NMR in cesareansection group. The results of this study showed thatthe cesarean section is not a main procedure to reducePMR. Appropriate indication and time of eesareansection and skill of operation are keys for reduction ofcesarean section rate and PMR in cesarean sectiongroup.