剖宫产指征和剖宫产率相关因素分析

Analysis of the Correlative Factors Between the Indication of Hysterotokotomy (H) and the Rate of Hysterotokotomy

目的分析近年来剖宫产率居高不下的主要影响因素.为制定降低剖宫产率的具体措施提供资料。方法将1995年至2004年期间在产科住院产妇的足月分娩病例进行回顾性分析。结果①剖宫产率呈逐年上升趋势,而阴道助产呈逐年下降趋势。②剖宫产占难产分娩的比例逐年增高。③1995至2001年间,相对头盆不称,胎儿窘迫、臀位、胎膜早破居于剖宫产手术指征的前4位.而2002年社会因素剖宫产的出现,至2003年及2004年均居第3位。④脐带绕颈作为剖宫产的指征,2003年及2004年分别居第5位及第4位。⑤单一因素行剖宫产的比例逐年增加.而多因素行剖宫产的比例逐年降低。结论剖宫产指征已远远超过单纯医学指征的范围,来自孕产妇的主观愿望和医疗行为中诸多因素的介入影响着分娩方式的合理选择。

OBJECTIVE To Analyze the main factors influencing the high rate of H in recent years, and to provide some information about reducing H rate. METHODS Making a retrospective analysis of term labor cases in in-patient obstetrics department of our hospital from 1995 to 2004. RESULTS ①H rate was increasing year by year, while normal labor rate decreasing.②The proportion of H in difficult labor was increasing.③The first four places of indication of Hwerere lative asynclitism fetal distre sbreech presentation and placen-tal abruption before 2001.Social factors causing H began to increase in 2002, and became the third place in 2003 and 2004.⑤Cord around neck was the fourth and fifth place in 2003 and 2004 respectively.⑥The proportion of single factor H was increasing year by year, while that of multiple fact or H was decreasing. CONCLUSIONS The factors H were beyond the medical indication category, and the reasonable selection of labor mode was influenced by subjective desire of puerperant and many other factors in medical practice.