非洲桑给巴尔奔巴地区剖宫产指征及原因分析

Clinical analysis of indications and causes for cesarean section on Pemba Island of Zanzibar Area of Africa

目的探讨和分析非洲桑给巴尔奔巴岛地区剖宫产的指征及原因,以提高产科质量。方法选择2008～2011年奔巴岛AbdullaMzee医院行剖宫产的564例病例,用回顾性分析的方法进行统计。结果奔巴岛Abdulla Mzee医院的剖宫产率为10.01%。剖宫产的主要原因为头盆不称(27.13%)、瘢痕子宫(23.40%)、重度子痫前期及子痫(13.30%)、胎儿因素(9.75%)、胎儿宫内窘迫(9.40%)、妊娠合并症(6.91%)等。结论剖宫产在处理难产及某些孕期合并症、并发症,降低孕产妇和围产儿死亡率方面发挥了极大的作用,但是在非洲这种医疗条件比较落后的地区,剖宫产仍存在着很大的风险,不必要的剖宫产术并不能减少产后出血率及新生儿发病率。当地医护人员应提高助产技术水平,建立并完善正规的产前检查系统,以提高产科质量。

Objective To improve the quality of maternity through exploring and analyzing the indications and reasons of cesarean section（CS） on Pemba island of Zanzibar Area of Africa. Methods A retrospective analysis was employed to make a study of 564 women with CS in Abdulla Mzee Hospital from January 2008 to December 2011. Results The cesarean section rate of Abdulla Mzee Hospital on Pemba Island was 10. 01%. The main causes of CS were cephalopelvic disproportion （ 27.13% ） , previous cesarean section （ 23.40% ）, preelampsia and eclampsia （ 13.30% ） , fetal distress （ 9.40% ） , factors of fetus （ 9.75% ） , pregnancy complications （ 6.91% ） etc. Conclusion Cesarean section plays a great role in the treatment of dystoeia, some pregnancy complications of pregnancy and delivery, other medical complications during pregnancy, reducing the maternal mortality and perinatal infants mortality, but in the area with relatively undeveloped medical conditions in Africa, CS still involves great risks. Unnecessary CS cannot reduce the incidence of postpartum hemorrhage and neonatal morbidity. The local medical staffshould improve the midwifery practice, establish and perfect the formal antenatal examination system to improve the quality of maternity.