Clinical Analysis And Countermeasures Investigation Of Changes Of Cesarean Section Rate And Indications In The Past Decade

Objective:(1) To describe the alteration of rate and indications of cesarean section infour hospitals of Xinzhou district of Jiangxi province from2002to2011;(2) To discussthe reasons of increased incidences of cesarean section;(3) To analyze the clinicalsignificance of all indications of cesarean section;(4) Based on the understanding of theindications of cesarean section, explore scientific ways to reasonably reduce the rate ofcesarean section.Methods: Collected, collated, and summarized all the cesarean section clinical data offour Shangrao hospitals from2002to2011. We retrospectively analyzed, observedand compared the changes of incidence and indications of cesarean section in these tenyears, and explored the factors that caused these changes. We used SPSS16.0packagefor data analysis.Results:(1) Changes in the incidence of cesarean section: the incidence of cesareansection Was increased in all four Shangrao hospitals from2002to2011. Thecomparisons of the incidence of cesarean section is statistically significant (P<0.05).And there is no difference among all four hospitals with different level.(2) Indicationsof cesarean section analysis: In the past10years, the major indications of cesareansection in all four Shangrao hospitals are: cephalopelvic disproportion, fetal distress,abnormal labor, uterine scarring, pregnancy complications, complications and social factors.(3) Changes of indications of cesarean section constituent ratio: differenthospitals has its all changing trend. Hospital A is a class A tertiary hospital. In all theindications of its all cesarean section cases in the past ten years, the number ofcephalopelvic disproportion and abnormal labor are becoming are reducing but thenumber of fetal distress, social factors are picking up. For hospital B, also a class Atertiary hospital, the number of cephalopelvic disproportion, fetal distress, abnormallabor and pregnancy complications are dropping, while only the number of socialfactors are increasing. For hospital C, a secondary hospital, among all the indications,only the social factors are increasing.; Hospital C is a class B tertiary hospital, all theindications except uterine scarring and social factors have their proportion decreased.All the above comparisons are statistically significant (P<0.05).(4) The order ofindications for cesarean section: although all four hospitals have slightly different ordersfor the c-section indications, the social factors became the first indication for all fourhospitals. It has become the main cause of cesarean section.Conclusion:(1) The ratio of cesarean section for Xinzhou district of Shangrao areincreasing.(2) Among all the indications of cesarean section, social factors becomingmore and more important. Its proportion has increased year by year. It has become themain reason affecting the local rate of cesarean section.(3) The changes of the c-sectionindications varies in different hospitals.