降低剖宫产率的措施与对策

Countermeasures for decreasing the rate of cesarean delivery

目的:通过分析剖宫产率增高的原因,探讨降低剖宫产率的措施与对策。方法:回顾性分析2012年1月至2015年12月剖宫产率及手术指征。结果:2012-2014年剖宫产率分别为45.69%、44.81%、44.23%,持续在较高的水平;2015年剖宫产率下降至38.43%,与2014年比较差异有统计学意义(P<0.05);2012年1月至2015年12月,无指征剖宫产率由42.60%下降至7.84%(P<0.05),而瘢痕子宫率、胎儿窘迫率呈上升趋势(P<0.05)。结论:瘢痕子宫再次妊娠是未来剖宫产率持续增高的重要原因,因此严格掌握剖宫产手术指征,提高医务人员的助产水平是降低剖宫产率的有效措施与对策。

Objective ： To analyze the causes of increasing cesarean rate and discuss the countermeasures for decreasing the cesarean rate of ce- sarean delivery woman. Methods： The cesarean rate and operation indication of cesarean delivery woman admitted into Duanzhou Maternal and Child Health Hospital of Zhaoqin from January 2012 to December 2015 were retrospectively analyzed. Results：The cesarean rate was 45.69 % in 2012, 44.81% in 2013, and 44.23 % in 2014, while it was 38.43 % in 2015. The cesarean rate in 2015 was less than that in 2014, and there was significant difference （ P 〈0.05 ）. The constituent ratio of cesarean section without medical indication decreased significantly from 42.60% in January 2012 to 7.84 % in December 2015, with the difference statistically significant （ P 〈0.05）. While the constituent ratio of scarred uterus and fetal distress was significantly increased, the difference statistically significant （ P 〈 0.05 ）. Conclusion：The secondary pregnancy of women with cicatricial uterus is the important cause of the increasing rate of subsequent cesarean section, and thus strictly grasping the operation indication and improving medical staff＇s delivery level are the effective to decrease the cesarean rate of cesarean delivery women.