.10 Cesarean Section Rate And Changes In Indications For Cesarean Section

Object:(1) To describe the alteration of incidence and indications of cesarean section in Lucheng People's hospital from 2001 to 2010; (2) To detect the association between alteration of indications and the increased incidence of cesarean section, and to find the operation related factors; (3) To explore specific measures to use cesarean section indications and to control the operation incidence properly.Method:We collected clinical materials for all the cesarean section cases in Lucheng People's hospital from 2001 to 2010. We observed and compared the changes of incidence and indications of cesarean section in these ten years, and analyzed potential factors which induce these above changes by retrospective analysis methods. We used SPSS 15.0 package for data analysis, compared of rates with X2 test. Test level taking P＜0.05 was considered statistically significant.Result:(1) Changes in the incidence of cesarean section:From 2001 to 2010, incidence of cesarean section was increased; the rate of natural delivery, forceps operation, fetal head suction and breech delivery were reduced; the rate of selective cesarean section was increased; the incidence of emergency cesarean section varied in different year (all of above P=0.000). The above alterations were associated with the number of cesarean section regarding each indication and the rank of different operation indications. (2) Compared indications of cesarean section of the first 5 years with the last 5 years, The number of cesarean section with not less than 2 indications in the first 5 years is lager than that of last 5 years and the number of cesarean section with one indication in the last 5 years is lager than that of first 5 years.We found a significant difference (X2=366.154, P=0.000).(3) Changes of indications of cesarean section before surgical:all indications in the first place by 2001-2002 along the pelvis; 2003-2005 for the first cephalopelvic disproportion; after 2005 as oligohydramnios. Breech presentation, umbilical cord around neck, fetal distress, placental aging, fetal macrosomia, placental abruption and placenta previa did not change significantly; the rank of pregnancy hypertension reduced; social factors, uterus with scar, abnormal progress of labor increased significantly and made the second, third and fourth rank by 2010. Suggestions:(1)Give scientific information of cesarean section to the people. To reduce non-medical factors in the choice of delivery pattern interference. (2)To promot new technology and make the vaginal delivery more comfortable and safe. (3) To improve the diagnosis and midwifery skills of obstetric staff.