Caesarean Section Without Medical Indications: A Clinical Analysis

Objective: To probe into the main factors in the cause of caesarean section without medical indications in clinical practice and to analyse the major reasons for the expectant women's request for caesarean section without medical indications in clinical practice.Methods: A case - control study is based on a random questionaire survey of 451,voluntarily completing a prenatal questionaire and a postpartum one 3 days after childbirth, of the full-term expectant women hospitalized in the department of obstetrics and gynecology of the First Affiliated Hospital of Fujian Medical University from June till November in 2009.The 451 studies fall into two major groups: the case group (group A) with 180 cases of caesarean section without medical indications and the control group including 162 cases of natural childbirth (group B) and 109 cases of caesarean section with medical indications (group C). After the survey, the data are processed and statistically analyzed by means of the SPSS17.0. statistical software.Results: 1.With group B as the control group, the statistical analysis shows the following 5 factors in the cause of expectant women in group A to request caesarean section: their age,their choice of delivery pattern, safe delivery pattern in their family's eyes,their family's choice of delivery pattern, their choice of delivery pattern in repeated pregnancy and childbearing.2. With group C as the control group, the statistical analysis shows the following 3 factors in the cause of expectant women in group A to request caesarean section: their resident places, their choice of delivery pattern,their being in hospital for childbirth in advance.3. The statistical analysis shows that the reasons for expectant women in group A to request caesarean section are various,such as fetal nuchal cord entanglement,fear of labor pain,and delayed or postterm pregnancy.Conclusions: 1. With group B as the control group, the statistical analysis shows that expectant women in group A are more inclined to choose caesarean section to terminate pregnancy in the following four cases: their being older in age, caesarean section being safer than vaginal delivery in their eyes and in their family's eyes, their being primiparae, their repeated pregnancy and childbearing.2.With group C as the control group, the statistical analysis shows that expectant women in group A are more inclined to choose caesarean section to terminate pregnancy in the following two cases: their coming from urban areas, their being in hospital for childbirth in advance.3.The study shows that fetal nuchal cord entanglement, fear of labor pain,delayed or postterm pregnancy, premature rupture of membrane(PROM), cicatrical uterus, antenatally suspected fetal macrosomia, medicall and surgical complications in pregnancy, and old primiparae are eight major reasons for the expectant women's request for caesarean section without medical indication in clinical practice. Binocular refractive errors, oligohydramnios, twin pregnancy, breech presentation, free choice of delivery time, precious fetus, mildly contracted pelvic inlet, vulvar varicose veins, fetal tachycardia, and battledore placenta also cause some expectant women's request for caesarean section without medical indication in clinical practice.