基层医院重复剖宫产的现状的探讨.docVIP

基层医院重复剖宫产的现状的探讨 　　【摘要】 目的：分析基层医院重复剖宫产现状并探讨进一步降低剖宫产率的措施。方法：选取本院2011年1月-2013年12月住院分娩重复剖宫产产妇总计981例，统计重复剖宫产率、重复剖宫产指征及所占比例。结果：统计2011-2013年重复剖宫产率分别为93.64%、47.30%、76.08%，平均重复剖宫产率为72.34%，重复剖宫产指征中要求结扎、社会因素、子痫前期、胎儿窘迫、产程异常居前五位。结论：重复剖宫产是多方面因素造成的，提高医患双方对剖宫产后再次妊娠的认识、加大宣传力度、鼓励剖宫产后阴道分娩、提高专业人员助产技术等可以有效降低重复剖宫产率，从而减少剖宫产手术带来的母儿风险。 　　【关键词】 瘢痕子宫； 重复剖宫产； 社会因素 　　Discussion on the Currant Situation of Repeated Cesarean Section in Primary Hospitals/YANG Ming，LI Yun-xiu，BAI Zhi，et al.//Medical Innovation of China，2015，12（29）：055-058 　　【Abstract】 Objective：To analyze the currant situation of repeated cesarean section in primary hospitals and discuss the measures to further reduce the rate of cesarean section.Method：The clinical data of 981 puerperae who had repeated cesarean section admitted to our hospital from 2011 to 2013 were retrospectively analyzed，the changes of repeated cesarean section rates and indications in different periods were statistically analyzed.Result：The repeated cesarean rates of our hospital were 93.64 %，47.30%，76.08% in 2011，2012 and 2013.The average cesarean section rate was 72.34%.The top five of the cesarean section indications were tubal ligation，social factors，preeclampsia，fetal distress，abnormal stage of labor.Conclusion：High repeated cesarean section rate is caused by many factors.It can be reduced by updating the conception of obstetricians and pregnant women，enhancing the propaganda of perinatal health care，encouraging vaginal birth after cesarean section，improving professional skills of midwives and so on，so as to reduce the risk of mother and son from cesarean delivery operation. 　　【Key words】 Scarred uterus； Repeated cesarean section； Social factors 　　First-author’s address：Tangxia Hospital of Dongguan City，Dongguan 523721，China 　　doi：10.3969/j.issn.1674-4985.2015.29.017 　　近年来，如何降低剖宫产率在国内外围产医学界逐渐引起关注和重视。我国的剖宫产率也因柳叶刀公布的剖宫产率排名而引起各级医院产科医生的重视。随着单独夫妇可生育二胎政策的放开，势必有一大批瘢痕子宫妇女再次妊娠，瘢痕子宫如何分娩的问题摆在了产科医生的面前。而部分妇女也因之前未尝试阴道分娩的经历或者有生育多胎的意愿等各种原因要求剖宫产后阴道试产。本院在2012年4月开