剖宫产指征变化10年回顾

目的:探讨近10年剖宫产率及剖宫产指征变化,以寻求降低剖宫产率着手点,保障母婴健康。方法:对近10年前(1993~1995年)后(2003~2005年)各3年剖宫产病例资料进行回顾性分析。结果:10年后剖宫产率为42.55%,显著高于10年前26.09%,P<0.01。在剖宫产指征中胎儿窘迫处于第1位,近10年有下降,P<0.01,但仍是剖宫产的首要原因;另外因臀位、妊娠期高血压剖宫产有显著降低,P<0.01,而因巨大儿、妊娠期糖尿病、剖宫产再孕、羊水过少剖宫产显著增多,P<0.01。10年来虽剖宫产率增高,新生儿窒息率下降无显著性,P>0.05。结论:10年来剖宫产率升高,构成比有所变化,但新生儿窒息率并未降低,因此应合理掌握剖宫产指征,指导孕妇合理饮食,减少妊娠期糖尿病和巨大儿的发生率,从而降低剖宫产率,减少剖宫产并发症的发生率。

The change of cesarean section indication in past 10 years

Objective:To study the changing trend of cesarean section rate and cesarean section indication in past 10 years.Methods:cesarean section cases occurred in our hospital in 1993～1995 and in 2003～2005 were analyzed retrospectively.Results:The cesarean section rate in 2003~2005 was 42.55%, which was significantly higher than that of 26.09% in 1993~1995,P<0.01.In the cesarean section indication, fetal distress decreased significantly, but still was the first cause, breech presentation and hypertensive disorder decreased significantly, fetal macrosomia , gestational diabetes mellitus(GDM), pregnancy after cesarean section , oligohydramnios increased significantly. Fetal distress rate did not decrease during 10 years.Conclusion:With the rise of cesarean section rate, the fetal distress rate does not decrease. Therefore, we should control cesarean section indication. Give women a suitable diet to decrease the rate of GDM and fetal macrosomia ,in order to decrease cesarean section rate.