Changes Of Indications Of First Cesarean Section In Our Hospital In The Past 10 Years

Objective:To study the changes of the rate of primary cesarean section and the indications of primary cesarean section in our hospital from 2010 to 2019.Methods:From January 1,2010 to December 31,2019,25533 pregnant women in the First Affiliated Hospital of Shanxi Medical University were selected,including 11787 cases of cesarean section,7516 cases of initial cesarean section and 21076 cases after removing scar uterus.Objective to compare the first cesarean section rate in different years and analyze the changes of the first cesarean section indications in 10 years,so as to provide some theoretical guidance for reducing the cesarean section rate in our hospital and even in our country.Results:Using the chi square test to compare the rate of primary cesarean section in2010-2019,the results showed that the chi square value was 284.117(P < 0.05),the difference was statistically significant,it can be considered that the rate of primary cesarean section in 2010-2019 was different.During 2010-2016,the rate of primary cesarean section in our hospital showed a downward trend.After 2016,the rate of primary cesarean section began to rise slowly.There was a statistically significant difference between the two years(P < 0.05).The rate of primary cesarean section in our hospital decreased significantly from 2015 to 2016,which was related to the introduction of the "expert consensus on standards and treatment of new labor process"(hereinafter referred to as "new labor process")in 2014.After 2016,the rate of first cesarean section began to rise slowly,which was due to the opening of "two child policy".The constituent ratio of indications for primary cesarean section between 2010 and 2019 was compared by chi square test,and the chi square value was 2007.49(P < 0.05).The constituent ratio of indications for primary cesarean section was statistically different between each year,so it can be considered that the constituent ratio of indications for primary cesarean section was different between 2010 and 2019.Fetal distress ranked the fourth in 2010 and 2011,and gradually decreased after2012,leaving the top five;macrosomia ranked the seventh in 2010 and 2011,leaping to the fourth in 2012,and then remained in the top five until 2018;placenta previa and vascular previa gradually increased from the eighth in 2010,and remained in the top five from 2015 to 2019;Serious complications and complications from 2010,except in 2012,are in the first order;social factors from 2010 to 2013 has always been in the top three,and even leaped to become the first in 2012,after 2014 gradually dropped out of the top five;conversion to cesarean section in the process of labor in addition to the proportion of significantly reduced in 2016,the rest of the year has no significant change in the order.Conclusion:The rate and indication of primary cesarean section are affected by economy,society,medical technology and national policy.Through strengthening the propaganda and education during pregnancy,carrying out painless delivery can significantly reduce the non-medical indications of cesarean section.Monitoring the biochemical indicators of pregnant women during pregnancy,giving individualized dietary guidance and reasonable intervention can reduce the cesarean section with serious complications and macrosomia as the indication.Placenta previa and vascular previa are serious challenges in our hospital.We should improve the diagnosis rate,early monitoring and active treatment.