The Change Of Cesarean Section Rate And Indications In Recent Seven Years

Objective:Cesarean section is an effective means,which can deal with high-risk pregnancies, abnormal labor, maternal and perinatal life-saving. With the maturity and perfection of various kinds of cesarean sections, other relevant developments in the field of medicine,which have made the safety of cesarean section greatly improved,and it is widely used in clinic; Research confirmed that the rise of cesarean section rate could reduce maternal and perinatal mortality within a certain range;Rapid development of social economy,the promoting of family planning,fetal is particularly precious, and pregnant women on vaginal delivery lack confidence,so they demand on cesarean section; The gradual increase of the doctor-patient contradictions and the medical disputes, no sound of medical legal regulations,constraints of Obstetricians choose clinical treatment strategies.and so on,these factors have helped cesarean section rate become the world’s first, caused wide spread concern in the field of obstetrics at home and abroad. So exploring the causes and control of high cesarean section rate has become the focus of study.For this reason,this study through analyzing the changes of seven years of cesarean section rate and indication,reasonable measures are put forward to control the cesarean section rate,to guide pregnant women choose rational way of delivery,to enhance quality of obstetrics department.Methods:Medical records of6402cases of cesarean section on Shanxi Medical University First Hospital between Jan.2006and Dec.2012were retrospectively analyzed,to describe the change of cesarean section rate and indication in seven years.Results: (1) In general,cesarean section rate was on the decline in seven years, the difference was statistically significant (X2=205.717, P=0.001<0.05)(2)The change of cesarean section indications in seven years, pregnancy-associated complications (X2=43.906, P=0.001<0.05) and uterus scar (X2=118.738, P=0.001<0.05) were on the rise in general,there were significant differences; social factors (X2=26.069, P=0.001<0.05) and fetal distress (X2=6.679, P=0.01<0.05) were on the decline in general,there were significant differences;the composition ratio of other cesarean section indications were similar in seven years.(3)In the composition of pregnancy-associated complications,the order from high to low is hypertensive disorders complicating pregnancy,pregnancy combined with external and internal diseases.placenta previa and placental abruption,diabetes mellitus,gestational,intrahepatic cholestasis of pregnancy.Conclusion:(1) In general, cesarean section rate was on the decline in seven years.(2)In the constitute of cesarean section indications, pregnancy-associated complications was the main reason, and was on the rise gradually. In the composition of pregnancy-associated complications, hypertensive disorders complicating pregnancy was displayed in the first place, then followed by pregnancy combined with external and internal diseases, placenta previa and placental abruption, diabetes mellitus, intrahepatic cholestasis of pregnancy.(3)The rate of social factors was on the decline.(4)To a new understanding of fetal distress, to definition of fetal distress strictly, so the rate of fetal distress was on the decline.(5)The rate of uterus scar took on ascendance trend.