武汉市剖宫产流行特征及其影响因素研究

目的 :初步掌握目前武汉市剖宫产在部分医院的流行特征 ,分析高剖宫产比的影响因素。方法 :对 2 0 0 2年 10月 6日～ 12月 10日在武汉市 4家医院分娩的 85 5例产妇进行回顾性分析。结果 :(1)剖宫产占 47 60 % ,阴道产占 5 0 88% ,阴道助产占 1 5 2 %。 (2 )剖宫产指征构成比居首位的是社会因素 (2 5 83 % )。 (3 )非必须剖宫产 165例 ,占分娩例数的 19 3 0 %。(4 )产妇选择剖宫产分娩考虑的首要因素是为了孩子健康 ,占 5 9 95 % ,其次是考虑只生一胎 ,占 45 45 %。假设无任何剖宫产指征、有无痛分娩或由信任的人陪伴 ,绝大部分产妇愿意选择阴道分娩。结论 :此次所调查医院的总体剖宫产率较高 ,其中非必须剖宫产比例较高是其重要原因。产妇及其丈夫不正确的分娩知识、态度和行为与产科医生不正确的态度和行为是非必须剖宫产的重要危险因素。

Study on the epidemiological characteristics and risk factors of cesarean section in Wuhan

Objective:To describe the epidemiological characteristics and identify the risk factors of high CS rate of cesarean section(CS) in Wuhan.Methods:In a cross sectional survey of 855 postpartum women at four hospitals with cluster sampling in Wuhan from October 6th 2002 to December 10th 2002. Results:(1)The CS rate was 47.60%(407), vaginal delivery rate was 50.88%(435),vaginal assist delivery rate was 1.52%(13).(2)Among all the CS indications, social factor (25.83%)ranked the first place.(3) Among all delivery women, 165 cases were unnecessary CS, which accounted for 19.30%.(4) The most primary factor, which pregnancy women considered to select CS before delivery was fetal safety(59.95%), followed by only one child in women's whole lives(45.45%). Supposition without medical indications, no labor pain or accompanied with close relatives, a majority of pregnancy women would select VD mode.Conclusion:The overall rate of CS is very high in surveyed hospitals, this result is mainly attributable to the increases in the proportion of unnecessary CS.Pregnancy women, husbands' incorrect delivery KAP and obstetricians' incorrect delivery attitude and practice are the important factors of the high proportion of unnecessary CS.