|
|
Analysis on the changes of cesarean section rate and the indication of cesarean section from 2012 to 2019 in our hospital |
CHEN Xiao-yun |
Department of Obstetrics and Gynecology,the First Affiliated Hospital of Fujian Medical University,Fujian Province,Fuzhou 350005,China |
|
|
Abstract Objective To study the changes of cesarean section rate and indication of cesarean section in our hospital from 2012 to 2019.Methods A total of 20 289 pregnant women who labor in the First Affiliated Hospital of Fujian Medical University from January 1,2012 to December 31,2019 were selected,among which 11 010 were delivered by cesarean section.The cesarean section rates in each year were compared,the trend of changes in indications of cesarean section operation were analyzed,and the measures of reducing the cesarean section rate were proposed.Results The rate of cesarean section in our hospital decreased year by year from 2012 to 2019.The rate of cesarean section in 2019 was 50.500%,which was lower than that of 61.159% in 2012,and the difference was statistically significant (P<0.05).Social factors and scar uterus ranked first and second among all indications of cesarean section operation.The proportion of scar uterus increased year by year,and it ranked second in the first two years and jumped to the first place in the next six years.On the contrary,the proportion of social factors has decreased year by year,it ranked the first in 2012-2013,the second in 2014-2018,and fell to the fourth in 2019,there were differences in comparison between the years (P<0.05).The pregnancy comorbidities and complications increased year by year,while the abnormal labor decreased year by year,the differences between the years were statistically significant (P<0.05).Conclusion The cesarean section rate of our hospital has decreased year by year in the past 8 years,but it is still relatively high.The main reason is the increased number of pregnant women with scarred uterus,pregnancy comorbidities and complications.The indications of the first cesarean section should be strictly controlled,the cesarean section without medical indications should be reduced as far as possible,the new stage of labor should be standardized,the full trial production should be given,and the vaginal delivery rate should be increased,so as to achieve the ultimate goal of reducing the cesarean section rate.
|
|
|
|
|
[1] |
Qin C,Deng Y,Chen WT,et al.Does previous cesarean section influence neonatal birth weight?A path analysis in China[J].Women Birth,2019,32(1):30 713-30 718.
|
[2] |
沈丽霞,陈海天,李珠玉,等.新产程标准管理下1089例自然分娩初产妇的产程特点分析[J].中华妇产科杂志,2019,54(2):93-96.
|
[3] |
Hidalgo-Lopezosa P,Hidalgo-Maestre M.Risk of uterine rupture in vaginal birth after cesarean:systematic review[J].Enferm Clin,2017,27(1):28-39.
|
[4] |
Liang J,Mu Y,Li X,et al.Relaxation of the one child policy and trends in caesarean section rates and birth outcomes in China between 2012 and 2016:observational study of nearly seven million health facility births[J].BMJ,2018,360:k817.
|
[5] |
Fitzpatrick KE,Kurinczuk JJ,Alfirevic Z,et al.Uterine rupture by intended mode of delivery in the UK:a national case-control study[J].PLoS Med,2012,9(3):e1001184.
|
[6] |
朱爱琳,谢咸晶,关婧雪,等.前次剖宫产后再次妊娠经阴道分娩成功的影响因素分析[J].同济大学学报(医学版),2019,40(5):598-602.
|
[7] |
Li Y X,Bai Z,Long DJ,et al.Predicting the success of vaginal birth after caesarean delivery:a retrospective cohort study in China[J].BMJ Open,2019,9(5):e027807.
|
[8] |
魏素花,叶晓东,仇黎丽,等.瘢痕子宫阴道试产成功的影响因素及妊娠结局:前瞻性队列研究[J].中华围产医学杂志,2017,20(9):649655.
|
[9] |
Menacker F,Declercq E,Macdorman MF.Cesarean Delivery:Background,Trends,and Epidemiology[J].Semin Perinatol,2006,30(5):235-241.
|
[10] |
Tanos V,Toney ZA.Uterine scar rupture-prediction,prevention,diagnosis,and management[J].Best Pract Res Clin Obstet Gynaecol,2019,59:115-131.
|
[11] |
董琴.剖宫产术后瘢痕子宫再次妊娠阴道试产的临床可行性评价[J].实用妇科内分泌电子杂志,2019,6(32):3-4,127.
|
[12] |
简跃,王枫.阴道分娩和剖宫产分娩对初产妇早期盆底功能障碍的影响[J].中国医药指南,2019,17(12):64-65.
|
[14] |
张艳平.无痛分娩方式的实施对降低剖宫产率的临床作用及影响[J].天津药学,2019,31(3):34-36.
|
[16] |
肖青青,高静,李幸,等.自由体位分娩对母婴分娩结局影响的Meta 分析[J].国际妇产科学杂志,2017,44(5):552-559,564.
|
[13] |
McKinnie V,Swift SE,Wang W,et al.The effect of pregnancy and mode of delivery on the prevalence of urinary and fecal incontinence[J].Am J Obstet Gynecol,2005,193(2):512-517.
|
[15] |
Bohren MA,Hofmeyr GJ,Sakala C,et al.Continuous support for women during childbirth[J].Cochrane Database Syst Rev,2017,7(7):CD003766.
|
[17] |
孙智晶,朱兰,郎景和,等.产后盆底康复锻炼对女性盆底功能障碍性疾病的预防作用[J].中华妇产科杂志,2015,50(6):420-427.
|
[18] |
时春艳,李博雅.新产程标准及处理的专家共识(2014)[J].中华妇产科杂志,2014,49(7):486-486.
|
[19] |
李励,刘胜楠,和儒林,等.新产程标准指导下剖宫产率及阴道试产成功率分析[J].第二军医大学学报,2018,39(6):610-614.
|
[20] |
曾晓明,郑九生,欧阳安.实施新产程标准结合胎头下降处理产程对母儿结局影响观察[J].实用妇产科杂志,2018,34(11):871-873.
|
|
|
|