9420例剖宫产手术指征临床分析

目的 通过对剖宫产手术指征的临床分析,探讨如何降低剖宫产率.方法 对笔者所在医院2005年1月～2009年6月住院分娩的孕妇13 791例,其中剖宫产9420例进行回顾性分析.结果 （1）5年来,笔者所在医院剖宫产率为68.3%,主要手术指征依次为社会因素占44.4%,胎儿窘迫占13.3%,羊水过少10.2%,ICP占7.8%,胎位异常占5.2%,巨大儿占3.5%,瘢痕子宫占3.2%,头位难产占2.9%.（2）5年来,以社会因素、胎儿窘迫、头位难产、巨大儿,臀位、癍痕子宫为剖宫产手术指征的比例明显增高,是笔者所在医院剖宫产率上升的主要原因.结论 剖宫产率的上升不单纯是医学问题,也是社会问题,应加强围产期保健,加强孕妇学校及多种媒体对孕妇及家属进行分娩宣教,减少妊娠合并症及巨大儿的发生率,正确处理头位难产,早期纠正胎位异常,指导孕期合理膳食及营养,严格掌握剖宫产指征,降低剖宫产率.

Clinical analysis in indications of 9420 cases caesarean section

Objective Through the clinical indications of cesarean section, to investigate the ways to lower the rate of Caesarean section. Methods To look back and analyze the 13791 cases of pregnant women who gave birth to a child in our hospital from January 2005 to June 2009,among which there were 9420 cases of Caesarean section. Results （ 1 ） the rate of Caesarean section is 68.3% and the main indicants in proper order are social factor（44.4% ） ,fetal distress（ 13.3% ） ,hypamnion （ 10.2 % ） , ICP （ 7.8 % ） , abnormal fetal position （ 5.2 % ） , giant baby （ 3.5 % ） , scarred uterus （ 3.2 % ） and dystecia of head birth （2.9%） ;（2 ）in the recent 5 years, the rate of Caesarean section caused by social factor, fetal distress, dystecia of head birth, giant baby, breech delivery and scarred uterus has raised distinctly and this has become the primary cause for the raising rate of Caesarean section in our hospital. Conclusion The raising rate of Caesarean section is not only a medical problem but also a social problem;it is necessary to reinforce perinatal care and the propaganda and teaching on parturition to a pregnant woman and her family members in Schools for Pregnant Women or by diverse mediums to lower the incidence rate of pregnancy complication and of giant baby ; we should treat dystocia of head birth properly, correct abnormal fetal position early, instruct the pregnant women in rational meals and nutrition for the duration of pregnancy, master the indicants of Caesarean section strictly and try to lower the rate of caesarean section.