近五年剖宫产率及剖宫产指征变化临床分析

Clinical analysis of rate and indications of cesarean section in recent five years

目的分析近5年来剖宫产率和剖宫产指征的变化,为进一步降低剖宫产率提供临床指导。方法回顾性分析2010年至2014年郑州大学第三附属医院分娩的孕产妇临床资料,比较了近5年来剖宫产率及剖宫产指征的变化。结果 1近五年剖宫产率逐年下降;2前3位剖宫产指征为社会因素,瘢痕子宫,妊娠合并症及并发症;社会因素剖宫产率逐渐下降,瘢痕子宫剖宫产率上升。结论经过多方努力,剖宫产率逐年下降,通过严把首次剖宫产指征,加强孕期围产保健及宣教,提高阴道助产技术,改变服务模式,制定剖宫产下降目标,逐步开展瘢痕子宫阴道试产等,有望进一步降低剖宫产率。

Objective To analyze the changes of cesarean section rate and its indications in recent five years and to fur- ther explore the measures that can reduce the cesarean section rate. Methods The clinical data of the gravida with ce- sarean section in our hospital from 2010 to 2014 were retrospectively analyzed. The changes of cesarean delivery rates and cesarean section indications were examined. Results （1）The rate of cesarean section has been descreased year by year （P 〈 0. 05）. （2） The most common indication of cesarean section were the social factors, previous cesarean section, preg- nancy complications, the cesarean section rate induced by social factor showed an decreasing trend year by year （ P 〈 0. 05）. the proportion of previous cesatean section among the indications of cesarean section showed an increasing trend year by year （P 〈 0.05）. Conclusion After our many efforts, The cesarean section rate tends to decrease in recent five years. So the key to reduce the rate of cesarean section is strictly controlling the first indications of cesarean section, strengthening the health education, improving the quality of obstetric department and improving vaginal delivery technolo- gy, and advocating vaginal birth for women with prior cesarean section can help further reduce the rate of cesarean section.