对855例急诊剖宫产的分析

目的探讨急诊剖宫产的手术指征分布,以寻求降低剖宫产率的方法。方法回顾性分析北京大学第一医院妇产科2002年1月至2003年12月两年间855例急诊剖宫产的手术指征。结果同期剖宫产率48.8%,其中急诊剖宫产占总剖宫产的37.3%,占总分娩数的18.2%。急诊剖宫产以胎儿窘迫为主,居首位,占急诊剖宫产的62.9%,占同期剖宫产的23.5%。新生儿窒息率在胎儿窘迫组为1.86%,与同期非胎儿窘迫组的1.26%,无显著差异(P>0.05)。术前诊断宫内感染168例,经胎盘病理和宫腔培养确诊83例,术前、后诊断一致率43%。急诊剖宫产发生在宫口开大3cm时最多,占26.6%。结论应严格掌握胎儿窘迫和宫内感染诊断标准,产程中积极处理减少活跃期停滞的发生,有助于降低剖宫产率。

Clinical analysis of 855 cases with emergency cesarean section

Objective Analyzed the indication of emergency cesarean section (CS) to decrease the rate of CS. Methods Analyzed the indication of 855 cases with emergency CS who were admitted in Peking University First Hospital from Jan.2002 to Dec.2003 retrospectively. Results The incidence of CS was 48.8%, in which the rate of emergency CS was ~37.3%. Fetal distress was the most common indication in emergency CS (62.9%). However, the rate of neonatal asphyxia in the group of fetal distress was 1.86% which was no significant difference with that of in the group of non fetal distress (1.26%), (P>0.05). 168 cases were diagnosed as intrauterine infection pre-operative, through placenta pathology and uterine cavity swab bacterial culture, 83 cases were made a definite diagnosis, the coincidence rate was 43%. The emergency CS were performed more likely in the 3 cm of cervical dilatation, the incidence was 26.6%. Conclusions To control the criterion of fetal distress and intrauterine infection will contribute to decrease the CS rate.