二孩政策后苍南地区产妇剖宫产原因分析及相关预防措施研究

Increasing rate of caesarean section in Cangnan region following two-child policy in China: causes and preventive measures

目的分析二孩政策全面实施后产妇剖宫产指征及影响因素,并制定相关预防措施,为进一步降低产妇剖宫产率提供临床依据。方法收集1 000例剖宫产产妇的年龄、孕周、孕史、产史、教育程度、家庭背景、产检次数及剖宫产适用指征,探究二孩政策全面放开后产妇剖宫产的主要原因,并制定相关的预防措施控制产妇剖宫产率。结果 1 000例产妇剖宫产原因中,瘢痕子宫占比32.4%,胎儿因素占比26.8%,社会因素占比14.8%,产道异常占比20.6%,产程异常及妊娠合并症并发症占比均为2.7%。胎儿因素中臀位占比34.1%,胎儿窘迫占比25.7%,巨大儿占比25.2%,珍贵儿占比11.8%,横位及其他因素分别占比2.7%、0.5%;社会因素中34.6%的产妇担心产道压迫胎儿,26.7%的产妇害怕分娩痛苦,25.4%的产妇旨在选择良辰吉日,而13.3%的产妇是受到亲朋好友的影响。妊娠合并症并发症中前置胎盘占比33%,羊水过少占比33%,胎盘早剥占比15%,妊娠合并高血压占比7%,子宫破裂、脐带前置、宫颈肌瘤均占比4%。结论剖宫产受多种因素影响,如产妇自身因素、社会因素、胎儿因素等;应积极做好产前检查、加强孕期指导,以减少各种因素影响,降低二孩政策后剖宫产率。

Objective To analysis the factors of the increase of caesarean section in Cangnan region following two-child policy in China so as to provide a clinical basis for further reducing cesarean section rate. Methods The clinical data of 1 000 parturient women accepting cesarean section delivery such as maternal age,gestational age,pregnancy history,production history,education,family background,frequency of production inspection,indications for caesarean section were firstly collected. An analysis was conducted into the data so as to find out the main factors that have led to the increasing rate of caesarean section. Results The results of cesarean section analysis showed that of the 1 000 subjects,scarred uterus accounted for 32. 4%,fetal factors 26. 8%,social factors 14. 8%,abnormal birth canal 20. 6%,abnormal labor 2. 7%,complication of pregnancy 2.7%. The results of fetal factors showed that breech factors accounted for 34.1%,fetal distress25.7%,fetal macrosomia 25.2%,preciousson 11.8%,transverse position 2.7%,other factors 0.5%. The results of social factors showed that 34.6% in parturient women worried about the birth canal,26.7% fear of childbirth,choosing a blessed date for delivery 25. 4%. 13. 3% women were affected by family and friends. The results of complications of pregnancy showed that placenta previa accounted for 33.3%,oligohydramnios 33.3%,placental abruption 15%,pregnancy combinedwith hypertension 7%,uterine rupture 4%,umbilical cord preposition 4%,cervical myoma 4%. Conclusions Caesarean section can be affected by many factors,such as maternal factors,social factors,and fetal factors,etc. Strengthening prenatal examination and pregnancy guidance can reduce the rate of cesarean section after the two-child policy.