剖宫产率及其相关因素

Analysis on correlation of caesarean rate

目的探讨剖宫产率上升与剖宫产指征、阴道手术助产和母儿病率之间的关系。方法对比分析1986、1997年我院产科1937例病人的剖宫产率、剖宜产指征、阴道手术助产率及母儿病率。结果1986年剖宫率16．2％，胎儿窘迫列剖宫产指征第2位（19．1％）；1997年剖宫产率29．1％，胎儿窘迫列指征第1位（42．7％），其回顾性诊断的正确率由57．1％降至15．6％。阴道手术助产率由23．1％降至12．5％。臀位剖宫产率由15．0％上升至85．0％；新生儿病率由23．7％降至9．3％；产后出血率则由6．3％上升至17．0％（P值均＜0．005）。结论剖宫产指征的变化和阴道手术助产率的下降是剖宫产率升高的主要原因。一定范围的剖宫产率上升降低了新生儿病率，增加了产后出血率。要防止剖宫产率的继续上升及对母儿可能造成的危害，需要从严格掌握剖宫产指征，提高产科医生的素质着手。

Objective To evaluate the relationship between caesarean indication, assisted vaginal delivery,perinatal morbidty and caeasarean rate, Method 1937 gravidas were retospectively reviewed.Result Thecaesarean rate was higher because the change of caesarean indication and the lower rate of operative vaginaldelivery. It's reducing neonatal morbidity and increasing the parturients morbidity. Conclusions Thecaesarean rate higher in a range on be reduced the neonatal morbidity.It must be prevented that the rate ofcaesarean was singificantly higyer to injury parturents and neonatals.