某二级医院的剖宫产原因分析及对策

Clinical analyses and its countermeasures of cesarean section in a second-class hospital

目的对比分析某县级医院2005年和2012年剖宫产率及剖宫产原因,探讨降低剖宫产率的干预对策。方法调取2005年和2012年3 660例产科住院分娩孕妇资料,采用回顾性调查研究,分年度统计剖宫产率,对剖宫产原因进行分类统计。结果 2012年某县级医院剖宫产率为40.83%,比2005年的46.83%下降了6个百分点,剖宫产原因分类2012年与2005年相比瘢痕子宫、头盆不称、要求剖宫产的比例明显上升;臀位、重度妊高症、羊水少、引产失败的构成比明显下降。结论 2012年剖宫产率较2005年下降,与医院对促自然分娩的重视、产科技术的提高、产前检查得到重视及规范有关。

Objective To analyze the cesarean section rates and its causes by contrasting medical data between 2005 to 2012 of a county-level hospital to explore the intervention measures to reduce the cesarean section rate. Methods 3660 cases＇ medical records of hospitalized pregnant women were analyzed by retrospective research to calculate annual cesarean section rates and classify its causes of cesarean birth. Results The cesarean section rates of the hospital were 40.83% and 46.83% in 2012 and in 2005 respectively. Compared with the results in 2005, the cesarean causes, the proportion of uterine scar, head disproportion and pregnant women＇s own request in 2012 had risen significantly. The composition ratio of breech position, severe pregnancy-induced hypertension, amniotic fluid shortage and induction failure decreased obviously. Conclusion Compared with that in 2005, the cesarean section rate decline in 2012 is attributed to hospital＇s high attention on promoting natural childbirth, obstetric technology improvement, prenatal examination and normative clinical procedures.