上海市闵行区近5年剖宫产率和剖宫产指征分析

目的]分析近5年上海市闵行区剖宫产率和剖宫产指征的变化,为制定干预措施提供依据。方法]回顾性分析闵行区近5年妇婴卫生工作季度报表和剖宫产的临床资料。结果]1剖宫产率仍呈上升趋势,阴道难产助产率呈下降趋势;2上海户籍孕妇剖宫产率明显高于非上海户籍孕妇,但差距逐年缩小;3剖宫产指征构成比前4位为胎儿窘迫、头盆不称、瘢痕子宫、社会因素。瘢痕子宫顺位逐年上升,2012年升为第一位,胎儿窘迫、头盆不称逐年下降,社会因素无明显变化。结论]剖宫产率居高不下的主要原因是社会、医疗、经济等因素导致剖宫产指征的放宽。需采取综合措施积极干预,将剖宫产率控制在合理范围。

Analysis on the rate and indications of cesarean section in Minhang District of Shanghai in recent five years

To analyze the changes in cesarean section rate and its indication in recent 5 years （from 2008 to 2012）, then providing evidence for intervention measures . Methods] Retro-spective analysis of recent 5 years was done for Minhang District maternity and infant quarterly statements and cesarean section clinical data . Results ] The rate of cesarean section still showed an upward trend, and vaginal birth rate declined year by year .The cesarean section rate of Shanghai census register was significantly higher than that of non Shanghai registration , but the gap was smaller and smaller .The first 4 indications for cesarean section were fetal distress , cephalopelvic disproportion , scar uterus , and so-cial factors.Scar uterus increased year by year , and in 2012 rose to the first one.Fetal distress, cephalo-pelvic disproportion decreased year by year , and social factors had no obvious change . Conclusion] The main reasons for the high rate of cesarean section were social factors , medical factors , economic factors and others.Comprehensive intervention measures should be taken actively for controlling the cesarean sec -tion rate in the reasonable scope .