上海市某镇剖宫产现况调查及其影响因素分析

目的:对上海市浦东新区高桥镇产妇剖宫产现况进行调查,分析其影响因素,探讨降低剖宫产率及加强孕期保健的方法.方法:随机抽取2010年7月至2011年6月期间上海市浦东新区高桥镇799例产妇为研究对象,利用相关医务人员在产妇出院后的两次上门家访时,采用自行设计的社会人口学调查表进行问卷调查.调查内容包括患者的一般资料以及剖宫产手术指征,分析产妇剖宫产的影响因素.结果:①剖宫产主要手术指征包括社会因素(32.22％)、妊娠合并症(27.93％)、胎位异常(8.38％)、难产(7.64％)、羊水异常(7.26％)、瘢痕子宫(6.70％)、胎儿窘迫(5.21％)、其他(4.66％).②剖宫产与孕妇基本情况(户籍、医疗保险)密切相关.结论:剖宫产因素构成复杂,其中社会因素影响最大；孕妇的户籍及医疗保险情况也会影响其生产方式.因此可通过产前健康教育,改变产时服务模式,完善助产技术,避免经济利益干扰等措施降低社会因素对剖宫产率的影响.

A Survey on Cesarean Section and Its Related Factors in Shanghai

Objective: To survey the current conditions of cesarean section and to analyze its influencing factors and discuss some plans to reduce cesarean section rate and enhance pregnancy care in Pudong Gaoqiao county of Shanghai.Methods: A total of 799 puerperae were chosen from July 2010 to June 2011 in Gaoqiao county,and self-designed postpartum questionnaire was adopted.The related factors to cesarean section were investigated.Results: ①Surgical indications of cesarean section include social factors(32.22%),pregnancy complications(27.93%),abnormal presentation(8.38%),difficult birth(7.64%),abnormal amniotic fluid(7.26%),cicatricial uterus(6.70%),fetal distress(5.21%),and others(4.66%).② Cesarean section is closely related to their general situations(such as household registration and medical insurance).Conclusion: Influencing factors of cesarean section are complicated,but social factors influence are the most important.Women’s household registration and medical insurance also have impact on cesarean section rate.Prevention methods are recommended to reduce cesarean section rate through pre-natal health education,changing the birth service mode,improving of the delivery techniques,and avoiding the interference of economical issues.