2014-2018年某院剖宫产率及剖宫产指征的变化情况分析

目的分析我院2014-2018年剖宫产率及剖宫产指征的变化,探讨降低剖宫产率的策略和措施。方法回顾性分析2014年1月至2018年12月于我院行剖宫产分娩的42385例产妇的临床资料,分析其剖宫产率及主要剖宫产指征。结果2016年的剖宫产率均低于2014年、2015年、2017年、2018年,差异具有统计学意义(P<0.05)。瘢痕子宫在二胎政策开放后所占比例明显增加;羊水过少及相对头盆不称所占比例呈现逐年下降的趋势。2014-2018年,母体因素所占比例均最高,胎儿因素及头盆因素所占比例逐年下降。另外,社会因素在二胎生育政策开放后仍呈上升趋势。结论2016年剖宫产率明显下降,瘢痕子宫在二胎政策开放后所占比例明显增加。临床需提高剖宫产术后再次妊娠阴道试产的比例、提高助产技术水平、发挥营养门诊及助产士门诊的作用、提高产科医生对胎心监护的正确解读以降低剖宫产率。

Analysis of the changes of cesarean section rate and indications from 2014 to 2018 in a hospital

Objective To analyze the changes of cesarean section rate and indications from 2014 to 2018 in our hospital and discuss the strategies and measures to reduce the cesarean section rate.Methods The clinical data of 42385 puerperae who received cesarean section in our hospital from January 2014 to December 2018 were analyzed retrospectively,and the cesarean section rate and main indications were analyzed.Results The cesarean section rate in 2016 were lower than that in 2014,2015,2017 and 2018,and the differences were statistically significant(P<0.05).The proportion of cicatricial uterus increased significantly after the second birth policy opened;the proportions of oligohydramnios and relative cephalopelvic disproportion decreased year by year.From 2014 to 2018,the proportion of maternal factors was the highest,and the proportion of fetal factors and cephalopelvic factors decreased year by year.In addition,social factors were still on the rise after the opening of the second birth policy.Conclusion In 2016,the rate of cesarean section decreased significantly,and the proportion of scarred uterus increased significantly after the opening of the second birth policy.In order to reduce the rate of cesarean section,it is necessary to increase the proportion of vaginal trial delivery after cesarean section,improve the level of midwifery technology,play the roles of nutrition clinic and midwife clinic,and improve the obstetricians’correct interpretation to fetal heart monitoring.