手术指征不充分剖宫产原因分析

Analysis on the cause for cesarean section with the insufficient indica tion

目的:分析手术指征不充分剖宫产的原因和探讨降低剖宫产率的措施。方法:对170例自然分娩和148例手术指征不充分的剖宫产作回顾性调查,调查内容包括了影响分娩方式的90个因素,采用单因素及多因素方法分析。结果:影响手术指征不充分剖宫产的因素有孕前体重指数、产前体重、产前体重指数、孕前与产前体重差、孕前营养、孕期营养、孕期补钙、妊高征、分娩年龄、婚孕年龄差、腹围、宫高、先露浮、B超提示胎盘钙化、胎儿双顶径、脐带异常、产时焦虑精神紧张、产妇剖宫产愿望、痛疼耐受力、文化程度、医务工作和干部职业、孕前体型肥胖、矮小;而身体体型高、经产、宫颈评分高,有自然分娩信心则是降低手术指征不充分剖宫产率的因素。结论:准确把握剖宫产指征是降低剖宫产率的关键。

Objective： To analyze the cause of cesarean section with the insufficient indication and to explore the measure for decreasing cesarean section rate. Methods： 170 cases of normal labor and 148 cases of cesarean section with insufficient indication were retrospectively investigated, including 90 factors influencing delivery mode, and were analyzed by single factor and muhifactor method, Results： The factors of cesarean section with insufficient indication included the weight index of pregestation, antenatal weight, antenatal weight index, interval weight between pregestation and labor, pregestation and perinatal nutrition, perinatal supplement calcium, pregnancy induced hypertension （PIH） , age of labor, interval age between marriage and pregnancy, abdominal circumference, fundal height, floating head, ultrasound showing placental calcification and cord round, mental anxious and stress, hope for cesarean delivery, pain endure, education level, vacation of cadre and medical, short or fat maternal body type. While high body type of pregnant women, muhiparous history, high cervical score and confidence in nature abortion reduced the cesarean section rate with insufficient indication. Conclusion： To master accurate cesarean section indication is the key of decreasing cesarean section rate.