四川省非医学指征剖宫产现状分析

目的:分析四川省非医学指征剖宫产现状及影响因素,寻求降低剖宫产率的对策。方法:随机抽取全省5个市进行调查,每个市随机抽取2个市级、2个县级、2个乡级助产服务机构进行数据收集,每个机构收集100份剖宫产病例,共对2824份有效问卷的剖宫产手术指征及影响因素进行分析。结果:非医学指征剖宫产占剖宫产总数的46.03%;不能忍受自然分娩疼痛、认为剖宫产安全、对自然分娩感到恐惧是选择剖宫产的主要原因;低龄、初产妇、无妊娠并发症、入院至分娩时间≥24小时组非医学指征剖宫产率高(P<0.01),脑力劳动组非医学指征剖宫产率高于体力劳动组(P<0.05)。结论:非医学指征剖宫产增加是近年来剖宫产率升高的主要原因。加强自然分娩的健康教育、推广应用分娩镇痛技术和处置难产技术以及政策支持是降低剖宫产率的有效措施。

An Analysis of Cesarean Delivery on Maternal Request in Sichuan Province

Objective:To analyze indications for cesarean delivery on maternal request(CDMR) and reveal status quo and influence factors in Sichuan Province,and explore countermeasures to reduce the rate of cesarean section.Methods:Five cities which randomly selected in province-wide were investigated,and 2 midwifery instituets at each levels(municipal,county and township;altogether 6 institutes) were selected for data collection in every city randomly.100 cesarean section cases were collected at each institution,and a total of 2824 cases with effective questionnaire concerning CS indications and influence factors were analyzed.Results:Cesarean delivery on maternal request accounted for 46.03% of the total number of cesarean section.Natural childbirth pain,concerning of safety,fear of natural childbirth are main reasons for the choice of cesarean section.Women of youngage,primipara,no complications of pregnancy,duration of admission to childbirth over 24 hours were main factors in CDMR group(P<0.01).The rate of CDMR is higher in women with intellectual work group than that of the manual labor group(P<0.05).Conclusions:The increase of CDMR in recent years is the main cause of rising rate of cesarean section.Strengthen the health education of natural childbirth,application technique for labor analgesia and difficult labour and policy support are the effective measures to reduce the rate of cesarean section.