选择性剖宫产的影响因素及干预措施的研究进展

Research Progress on Influencing Factors and Intervention Measures of Cesarean Delivery on Maternal Request

在过去几十年里,剖宫产率在全世界范围内呈上升趋势,选择性剖宫产的过度选择是其主要原因之一。这不仅对孕产妇、胎儿和婴儿造成不良影响,也给卫生保健系统带来巨大的经济压力。近年来我国采取一系列的干预措施使得整体剖宫产率有所下降,但选择性剖宫产占比仍在持续上升。2018年WHO发布一系列降低全球剖宫产率的非临床干预措施的循证建议。以该建议为框架,结合我国具体情况,概述选择性剖宫产的现状、影响因素及国内外的干预措施,以期为促进自然分娩的临床实践提供参考。

In the past few decades, cesarean section rate has been increasing worldwide, the overuse of selective cesarean section is one of the main reasons. It not only has a negative impact on maternal and fetal babies, but also brings a huge economic pressure to the health care system. In recent years, China has taken a series of intervention measures to reduce the overall cesarean section rate, but the proportion of selective cesarean section is still rising. WHO published a series of evidence-based recommendations for non-clinical interventions to reduce global cesarean section rates in 2018. Based on the proposal, the present situation, influencing factors and intervention measures of selective cesarean section are summarized in order to provide reference for promoting the clinical practice of natural delivery.