| Objective Through the analysis of the two hospitals in 10 years changes in the rate of cesarean section, discusses the cause of high cesarean section rate, find out the method of dealing with and guide the clinical work.Methods Zhongnan hospital between January 2004 and December 2004, ten years in all cases of hospitalized childbirth, a total of 13421 cases, among which 4067 were natural childbirth,9354 cases of cesarean delivery. Inner Mongolia hospital in January 2004-December 2013 10 years all cases of hospital childbirth, a total of 22552 cases, including natural birth 12664 cases,9888 cases of cesarean delivery. Zhongnan hospital and the hospital of Inner Mongolia from 2004 to 2013, the clinical data of all cases of cesarean section in 10 years, the trend of the observed changes in the rate of cesarean delivery for 10 years, compare the indications of 10 years cesarean delivery, cesarean section rate rise and cesarean section indications changes the relationship between them, at the same time comparing the differences of two hospitals, the existence of regional differences.Results Two hospitals in 10 years, the trend of the total number of births increased year by year, cesarean section rate were significantly different. This decade of zhongnan hospital cesarean delivery rate was 74.63%, the highest minimum 62.95%, average cesarean delivery rate was 69.70%, the cesarean delivery rate is lower than the average of nearly two years, the incidence rate of comparative difference was statistically significant (?2-93.089, P<0.001).10 years of Inner Mongolia hospital cesarean delivery rate was 48.77%, the highest when the minimum is 33.07%, the average cesarean delivery rate was 43.85%, nearly six years of cesarean section rate were higher than the average, has a tendency to rise, and the comparison of cesarean section rate difference was statistically significant (?2=159.040,P<0.001). Two hospitals from 2004 to 2013 in transverse comparison results show that each year the cesarean delivery rate comparison, the difference had statistical significance (P< 0.001), central south hospital,10 years of total cesarean delivery rate was 69.70% (68.92 -70.47%), the Inner Mongolia hospital ten years total cesarean delivery rate was 43.85%(43.20- 44.49%), central south hospital cesarean section rate was significantly higher in Inner Mongolia hospital (?2=2260.139,P<0.001).1.The fetal factors:Fetal distress factors present obvious decline in two hospitals (zhongnan hospital:?2=54.281,P<0.001;Inner Mongolia hospital:?2=62.278,P<0.001). Macrosomia, abnormal position (mainly refers to the breech), abnormal fetal growth restriction and amniotic fluid as a cesarean section indications, present obvious rising trend in two hospitals, including infant and fetal growth restriction in two hospitals have statistical significance. Double (multiple) tire as a cesarean section indications, in this decade, present obvious rising trend in zhongnan hospital, with statistical significance (chi-square=79.588, P<0.001), in Inner Mongolia hospital has a rising trend, but is not obvious. Overall,10 years fetal factors cesarean section indications of the overall change in the two hospitals have statistical significance (zhongnan hospital:?2=215.324,P<0.001;Inner Mongolia hospital:?2=215.324,P<0.001). 2. Mother factors:Pregnancy complications and complications and scar uterus as a cesarean section indications, in this decade, the two hospitals in the rising trend, and were statistically significant (P<0.001). Premature rupture of membranes in itself is not a cesarean section indications, in this decade, zhongnan hospital in slightly down (chi-square=0.451, P=0.451), the Inner Mongolia hospital has some upward trend, but it was not statistically significant (?2=0.451,P=1.000). Placental factors as cesarean section indications, in this decade, zhongnan hospital present obvious rising trend (chi-square=40.044, P< 0.001), Inner Mongolia hospital also rise, but not obvious (?2=40.044, P<0.001). Threatened preterm labor is not a cesarean section indications, premature in two hospitals tend to rise, and were statistically significant (P<0.001). Labor is not cesarean section indications, general decline in two hospitals, zhongnan hospital of statistically significant (?2=48.993,P<0.001). Overall,10 years mother factors cesarean section indications of the overall change in the two hospitals have statistical significance (zhongnan hospital:?2=427.687,P< 0.001; Inner Mongolia hospital:?2=368.609,P<0.001).3. social factors:Precious son (including ivf), umbilical cord entanglement and women as a cesarean section indications, in this decade, two hospitals in general is on the rise, the statistically significant factors for women (zhongnan hospital:?2=65.378,P<0.001;Inner Mongolia hospital:?2=46.554, P<0.001). No indications of cesarean section in this decade, showed a trend of decline, but still occupies certain proportion, and statistically significant (zhongnan hospital:?2=44.262, P<0.001; Inner Mongolia hospital:?2=41.125, P<0.001).In addition, zhongnan hospital overall changes in 10 years, social factors cesarean section indications(?2=101.539,P<0.001),Inner Mongolia hospital are also statistically significant (?2=90.858,P<0.001).Conclusion Through the study of this article, we can see the development of cesarean section surgery and the change of the cesarean section indications are that varies along with the development of social economy and culture.Through the north and south two hospital cesarean delivery status analysis and comparative study, found that two hospital cesarean section rates are high, far more than the world health organization (WHO) standards (15%).A greater difference between two hospital cesarean section rate (zhongnan hospital cesarean delivery rate was 69.70% on average, Inner Mongolia hospital cesarean delivery rate was 43.85% on average,), it is because the regional economy, cultural background, population, and to the local medical status caused by different.Through the analysis of the present situation of cesarean delivery, can for macrosomia, scar uterus, pregnancy complications, labor management, women and no indications aspects such as strengthening management, can reduce cesarean section rate above 20%.At the same time, we should strengthen antenatal education, promotion guide and labor analgesia, create conditions for development, actively promote the new labor figure.Obstetrician at present stage focus in intrapartum help pregnant women not only solve the problem of delivery, should pass forward and reduce complications. |
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