Analysis On The Incidences And Indications Of Cesarean Section In Different Grade Hospitals In Changchun

Objective: Explore on differences and correlations of the incidences andindications of cesarean section in different grade hospitals in Changchun. Toanalyze the defects of maternal health care and obstetricservices.Furthermore,to guide how to grasp rationally the indications ofcesarean section, and to reduce effectively the incidence of cesarean section.Methods: Selected three representative hospitals of Changchun:TheSecond Hospital of Jilin University(advanced hospital),and set it group A.TheNong’an People’s Hospital (general hospital), set it group B. Yushu Maternaland Child Health Hospital (specialist hospitals),which is set to group C.Retrospective survey of7597pregnant women who delivered in the threehospitals from January2011to December2011.To investigate theirsociodemographic characteristics, mode of delivery, the rate and indications ofcesarean section.Established database using EXCEL2007.Entry data receivedand examined logic error by professionals. Analyzed of dates using SPSS16.0for windows and compared of rates with X2test.Results: The incidence of cesarean section of group A was75.75%, groupB was81.56%, group C was75.14%.The differences among three groupshave no statistically significant,(P>0.05).The first indication of cesareansection in three groups are all the social factor,compared the incidence ofsocial factor between group A and C,we find it is higher in group C, and thedifference has statistically significant (P <0.05).The second indication ofcesarean section in group A is pregnancy complications, compared withanother two groups (B, C),the differences have statistically significant (P<0.01).The second indication of cesarean section in group B is cephalopelvicdisproportion, compared with another two groups, the difference have statistically significant (P<0.01).The uterus with scar make the rank at the topthree in all indications of three hospitals, the differences of composition amongthe groups have no statistically significant(P>0.05). Pregnant women’s age,education level, occupation, BMI of pre-pregnancy,health insurance forms,suffering risk factors during pregnancy, etc. these have a certain effect on theincidence of cesarean section.Conclusions:(1)The incidence of cesarean section of Changchun isoverall high,and it is no significant correlation with grades of hospitals.(2)Thesocial factor become the principal reason of cesarean section inChangchun.(3)Pregnancy complications is the second indication of cesareansection in advanced hospital.(4)Uterus with scar make the rank at the topthree in all indications of three hospitals.The second indications of cesareansection in general hospital is cephalopelvic disproportion,but, there are about55%cases which was diagnosed cephalopelvic disproportion in generalhospital has no enough evidence which is based on the diagnosis ofcephalopelvic disproportion.The diagnosis were only based on subjectiveviews of obstetricians.(5)Fetal factors have no significant difference among thedifferent grade hospitals.(6)The persons who require cesarean sectionswithout medical reason are rising,the most three thought factors involve:Refusing to vaginal delivery because fearing pain; Picking the auspicious timewhich the baby born,Worrying about failure of vaginal delivery and beingforced to cesarean section (7)Age, education level, occupation, pre-pregnancybody mass index, health insurance type and risk factors during pregnancyaffect the cesarean section rate.