摘要
目的:分析某市三甲医院2014年至2018年剖宫产率及剖宫产指征的变化,分析二胎政策后的高剖宫产率的原因。方法:对2014年至2018年住院分娩的15531例产妇的临床资料进行回顾性分析,分析二胎政策逐渐开放后的剖宫产率及剖宫产指征的变化情况。结果:2014年至2018年剖宫产指征所占比例最高的是瘢痕子宫(28.93%),并且逐年升高,差异有统计学意义(P<0.05);初次剖宫产中妊娠合并症及并发症所占比例逐年升高;社会因素2017年(23.88%)、2018年(24.17%)所占比例和巨大胎儿2017年(8.30%)、2018年(4.92%)所占比例均较2014年的30.27%、13.61%有所下降;根据二胎开放时间分组后发现瘢痕子宫所占比例三组差异有统计学意义(P<0.05),社会因素、巨大胎儿因素有所下降,妊娠合并症及并发症却有所升高,但是差异无统计学意义。结论:首次剖宫产是剖宫产率居高不下的首要因素,多种因素共同影响着剖宫产率;控制首次剖宫产率是关键,同时需要多种措施共同干预,对孕产妇给予孕前,孕期及产前的健康教育至关重要。
Objective: To analyze the changes of cesarean section rate and cesarean section indications in a third-class a hospital of a city from 2014 to 2018 in order to analyze the reasons for the high cesarean section rate after the two-child policy. Methods: A retrospective analysis was conducted on the clinical data of 15,531 puerpera who were hospitalized in childbirth from 2014 to 2018 to analyze the cesarean section rate and the changes of cesarean section indications after the second child policy was gradually opened. Results: From 2014 to 2018,the highest rate of cesarean section was scar uterus (28.93%),which increased year by year,with statistically significant difference (P < 0.05). The proportion of pregnancy complications and complications in the first cesarean section increased year by year. The proportion of social factors in 2017 (23.88%),2018 (24.17%),and the proportion of giant fetuses in 2017 (8.30%) and 2018 (4.92%) all decreased from 30.27% and 13.61% in 2014.According to the opening time of the second fetus,the ratio of scar uterus was statistically significant (P < 0.05),social factors and giant fetal factors were decreased,but pregnancy complications and complications were increased. Conclusion: The first cesarean section is the primary factor of high cesarean section rate. Control of the rate of the first cesarean section is the key,at the same time needs a variety of measures to intervene together,for pregnant women to give pre-pregnancy,pregnancy and prenatal health education is crucial.
作者
郭艳巍
刘新伟
袁晓明
单伟颖
GUO Yanwei;LIU Xinwei;YUAN Xiaoming(Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China)
出处
《河北医学》
CAS
2019年第10期1724-1729,共6页
Hebei Medicine
基金
河北省科技计划项目,(编号:162777102D)
关键词
剖宫产指征
初次剖宫产
剖宫产瘢痕
子宫剖宫产率
Indications of cesarean section
First cesarean section
Cesarean section scar uterus
Cesarean section rate
