剖宫产率上升及剖宫产指征变化的临床分析

Clinical analysis on the increased rates and changes of indications for cesarean section

目的:分析剖宫产手术指征及剖宫产率变化,探讨降低剖宫产率的措施。方法:对我院实施剖宫产手术的1999年度282例与2009年度783例的剖宫产指征进行对比分析。结果:1999年剖宫产率为16.6%(282/1 696),2009年剖宫产率为47.3%(783/1 654),二者差异具有显著性(χ2=364.23,P<0.005)。1999年剖宫产指征前三位依次为头盆因素及产程异常、产妇因素和胎位异常,而2009年相应为社会因素、产妇因素和头盆因素及产程异常。结论:社会因素已转变为剖宫产率升高的主要因素。提高产前诊断水平、加强医患沟通和加大产前宣教力度是降低剖宫产率的主要措施。

Objective：To analyze the growing rate of cesarean delivery and changes of indications associated with cesarean section for measures to reduce the rates. Methods ： We conducted a comparison between the indications of cesarean section of 282 cases in 1999 and 783 in 2009 in Tongling People＇s Hospital. Results：Primary cesarean delivery accounted for 16.6% （282/1 696）in 1999 and 47.3 % （783/1 654 ） in 2,309, and the rates for the two years were significantly different （ X2 = 364.23 ,P 〈 0. 005）. In 1999, the top three indications for cesarean section were associated with delayed delivery due to cephalopelvic disproportion, maternal preference and abnormal fetal position, and yet, the indications ranked from social factors and maternal preference to abnormal labor involved in maternal pelvis. Conclusion ： Social factors appeared primarily responsible for the preference of cesarean delivery.. Improvement of the prenatal diagnosis and doctor-patient communication and patiert education before delivery would potentially keep cesarean section under lower rates.