摘要:
目的 分析二胎政策开放前后剖宫产率和剖宫产指征的变化。方法 选取某三甲医院2014年1月-2017年12月12 230例住院分娩孕产妇病历,收集临床资料,进行回顾性分析全面二胎政策实施前后某三甲医院剖宫产率的变化及剖宫产指征的顺位变化。结果 二胎政策实施后剖宫产率为57.31%,明显低于实施前的68.75%;二胎政策实施后,剖宫产前五位的指征依次为:瘢痕子宫、妊娠合并症和并发症、社会因素、胎位异常、难产。其中因疤痕子宫剖宫产的发生率33.42%,显著高于实施前的16.67%,差异有统计学意义(P<0.001);因胎儿窘迫、难产、巨大儿和多胎妊娠剖宫产的发生率显著增加,差异有统计学意义(P<0.001)。因社会因素剖宫产的发生率显著下降(P<0.001),差异有统计学意义。结论 二胎政策开放后剖宫产率有所下降,剖宫产指征顺位发生变化,社会因素所致剖宫产率显著下降,但疤痕子宫为指征的剖宫产率反而升高。因此,建议做好一胎产妇分娩方式的掌控和加强疤痕子宫阴道试产的管理。
Abstract:
Objective To analyze the changes of the rate and the indications of cesarean section before and after the implementation of two-child policy.Methods 12 230 medical records of hospitalized pregnant women in A third grade hospital from January 2014 to December 2017 were randomly selected and retrospectively analyzed. Changes of cesarean section rate and the order of cesarean section indications in a third-class A hospital before and after the implementation of the comprehensive second-child policy.Results After the implementation of two-child policy, the cesarean section rate was 57.31%, significantly lower than 68.75% before the implementation (P<0.001). After implementation, the top five indicators of cesarean section were scar uterus, pregnancy complications, social factors, abnormal fetal position and dystocia. After implementation, the proportion of scar uterus as the cesarean section indicator was 33.42%, significantly higher than 16. 67% before implementation (P<0.001). After implementation, the proportions of fetal distress, dystocia, macrosomia and multiple pregnancies as the cesarean section indicators were significantly higher than those of before implementation (P<0.001). After implementation, the proportion of abnormal fetal position as the cesarean section indicator increased significantly (P<0.05), and the proportions of social factors decreased significantly (P<0.001).Conclusions After the implementation of the two-child policy, the cesarean section rate shows a downward trend, The order of indications for cesarean section changed. The rate of cesarean section due to social factors decreased significantly, however, the rate of cesarean section indicated by scar uterus increased. Therefore, it is suggested that we should control the mode of delivery and strengthen the management of scar uterus and vagina trial delivery.
百度学术
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