上海市剖宫产现况调查情况分析

目的 为了解市接产医院剖宫产情况。方法 于１９９８年７月，对本市７５所二、三级接产医院的产科病史及医和人员进行了调查。结果 全市剖宫产率为４５．９％，其中初产妇占８７．４％；选择性剖宫产占４０．４２％。主要指征构成依次为：胎儿窘迫（２７．５４％），相对性头盆不称（１２．８７％），社会因素（１０．１５％）及臀位（９．０８％）。进一步对剖宫侃进行评审分析，指征掌握正确率为７３．８８％。以胎儿窘迫为指征

Study on the situation of cesarean section in Shanghai

Objective In order to learn the situation of cesarean section in Shanghai. Methods We carried out a retrospective study for all hospitals with obstetrics in Shanghai. Results The average rate of cesarean section was 45. 9%. Among them, 87.4% were primiparae and 40.42% were elective. The rank order of indications for cesarean section were as follows: fetal distress (27.54%), cephalopelvic disproportion (12.87%) social factor (10.15%) and breech presentation (9.08%). We further analysed the indications of cesarean section to see if they were appropriately fitted. We found that the correct rate was 73.88% . Lack of evidence for fetal distress accounted for 39.85, one third of cephalopelvic disproportion also were devoid of evidence. Conclusion These results suggest that the cesarean section rate can be reduced to 30% if the indications for cesarean section are appropriately used. 4 corresponding measures are provided for the further reduction of cesarean section: education for obstetric medical staff to master the indications of cesarean section strictly, especially in dealing with fetal distress, cephalo pelvic disproportion and breech presentation correctly; health education for pregnant women and their family members to change their blind faith on cesarean section and make full preparation for vaginal delivery; changing the model of obstetric service and popularizing the DOULA accompanied delivery; carrying out the audit of cesarean section to arouse the attention of administrators.