温州市某医院降低剖宫产率应对措施探讨

Exploration of Countermeasures to Decrease Cesarean Section Rate in Wenzhou

目的:分析剖宫产率及剖宫产指征的变化,探讨降低剖宫产率的应对措施。方法:回顾性分析2001年1月至2009年12月以及2010年6月至2011年6月剖宫产的临床资料。结果:剖宫产率逐年上升;随机选取2003年及2007年剖宫产指征构成比比较,发现社会因素上升最快,其次是瘢痕子宫;2010年6月开始采取分娩镇痛、导乐分娩等措施,剖宫产率降低,其中社会因素所占构成比下降明显,瘢痕子宫跃居剖宫产指征第一位。结论:通过开展分娩镇痛、导乐分娩、孕期宣教以及应用有效的促宫颈成熟药物等措施,可有效减少以社会因素等指征的剖宫产率,瘢痕子宫已成为主要剖宫产指征,严格掌握首次剖宫产指征和瘢痕子宫再次妊娠选择阴道分娩成为降低剖宫产率的关键。

Objective： Analyzing the variation of the cesarean section rate and the indication for cesarean section to explore the counter- meassures to decrease cesarean section rate. Methods： Cesarean section cases occurred from Jan.2001 to Dec 2009,from Jun.2010 to Jun.2011 were analyzed retrospectively. Results： The cesarean section rate increased steadily. Comparing the indications for cesarean section in 2003 with that in 2007, it found that the indications for cesarean section for social factors rised quickly, followed by scarry uterus. Since Jun.2010 measures were taken, the cesarean section rate was dropped. It affected the indications for cesarean section for social factors utmostly. Scarry uten~,s became the first major indication for cesarean section. Conclusion： The cesarean section rate may decrease dramaticly through carry out labor analgesia and doula delivery roundly, strengthen gestational health education and maternal health care, apply effective drug for cervical ripening. Mastering the indication for the primary cesarean birth strictly and select vagianl birth after cesarean delivery are the key factors to reduce the rate of cesarean section.