剖宫产指征1164例分析

Analysis of the Indications for 1164 Cases of Cesarean Section

目的:分析我院妇产科剖宫产指征构成及剖宫产率居高不降的原因,探讨降低剖宫产率的对策。方法:对我院2003-2007年1164例剖宫产病例进行回顾性分析。结果:剖宫产率为38.96%(1164/2988)。主要指征依次为:社会因素26.55%(309/1164),头盆不称16.24%(189/1164),胎儿宫内窘迫14.69%(171/1164),疤痕子宫9.54%(111/1164),臀位8.85%(103/1164),巨大儿7.22%(84/1164),产程停滞6.79%(79/1164)等。(2)5年来以疤痕子宫为剖宫产指征的比率明显升高,一定程度上反映了往年剖宫产率不降所带来的负面影响。结论:应加强围产期保健,正确处理难产,严格掌握剖宫产指征,进行心理调控是降低剖宫产率、提高产科质量的关键。

Objective：To analyze the structure of cesarean section indications and the reasons of high cesarean section rate in our department of obstetrics and gynecology and to try to find the strategy of decreasing the cesarean section rate. Methods：The clinical data of 1 164 cases of cesarean section in our hospital from 2003 to 2007 were analyzed retrospectively. Results：（1）The rate of cesarean section was 38. 96 % （1 164/2 988）. The main indications were as following： social factors 26. 55% （309/1 164）, cephalopelvic disproportion 16. 24% （189/1 164）, fetal distress 14. 69% （171/ 1 164）,scar uterus 9. 54% （111/1 164）, breech presentation 8. 85% （103/1 164）, fetal macrosomia 7. 22% （84/ 1 164）, arrested labor 6. 79% （79/1 164）, and so on. （2） During the past five years, the scar uterus ratio in cesarean section indications increased significantly. To some extent, this reflects the negative impact of the high rate of cesarean section in former years. Conclusion： We should strengthen perinatal healthcare, handle dystocia correctly, control the indications of cesarean section strictly, and through psychological control can reduce cesarean section rate and improve obstetrics quality.