Analysis of cesarean section rates and indications for
【Abstract】 Objective: To analyze the past four years, the trend of cesarean section rate and the percentage of cesarean section indication, in order to develop specific
measures to reduce the rate of cesarean section to provide information. Methods: from 2003 to 2006 in our hospital between full-term delivery of maternal obstetric hospital
patients were analyzed retrospectively. Results: ? The cesarean section rate showed an
upward trend year after year, while the fetal head to attract patients, such as vaginal hip traction midwifery declining trend. ? no indication for cesarean section (social
factors), the ratio increased year by year. Conclusion: At present, indications for
cesarean section has far exceeded the scope of purely medical indication, more and more pregnant women and doctors from the subjective views of impact on the rational choice of delivery mode.
Key words cesarean section cesarean section rate in full-term delivery of social factors
Cesarean section is not a mode of delivery, but one important way to solve a difficult birth. Cesarean section, after all, is a kind of surgery, is a natural life-
generating process of the destruction of the maternal and child health is much higher
than the damage caused by natural delivery. World Health Organization identity cesarean section rate of 15%, China's medical profession that should be controlled at 20% ~ 25%, while most of the hospitals reported that at present about 40% to 60%, or
even as high as 70% ~ 80%. With the socio-economic and medical development, the
changes in people's attitudes and health behavior intervention of a number of social factors, making indications for cesarean section, great changes have taken place,
cesarean section rate is rising year by year.
1 Data and methods
1.1 General Information All the cases were from our hospital from 2003 to 2006 full-
term delivery of maternal hospital cases.
1.2 Methods for the above-mentioned cases of data-year total number of deliveries,
cesarean section rate, fetal head aspiration rate and the proportion of a variety of indications for cesarean section and so on retrospective analysis of statistics related to
the composition ratio, to demonstrate its occurrence over time changes, further analysis of the factors affecting these changes.
1.3 Statistical treatment using the composition of the corresponding ratio.
2.1 2003 ~ 2006 cesarean section rate was increased year by year trend, the fetal
head aspiration, hip traction is a declining trend (see Table 1). Table 1 cesarean section rate for each year, hip traction rate, the rate of fetal head to attract total number of deliveries accounted for more than
2.2 The surgical indications for cesarean section and changes in the composition ratio
Cesarean section indications mainly include the relative cephalopelvic disproportion, abnormal head position (first to reveal abnormal), fetal distress, breech
presentation, uterine scar, pelvic abnormalities, pregnancy-induced hypertension, twin
pregnancy, social factors (no indication of cesarean section), etc. The indications for each year is slightly different than the sequence and structure (see Table 2). Table 2 the
main surgical indications of cesarean section for each year of the constituent ratio
Retrospective data from the above can be seen in recent years, cesarean section rates were rising year after year, in particular, caused by social factors, cesarean
section rate increased significantly, while the hip traction, such as vaginal aspiration of fetal head to help decreasing production technique, the reason there are aspects of scientific and technological progress, but also social and human factors.
3.1 Technological Factors
3.1.1 due to cesarean section to simplify and skilled, so that the increasingly shorter operative time, and continuously improved incision and separation technology that enables a significant reduction in injuries and bleeding, and abdominal incision suture and incision of new products such as adhesive applications, making surgery a more attractive appearance. As well as the advances in prenatal monitoring tool, allowing physicians to detect anomalies during delivery, cesarean section as soon as possible, so cesarean section rate increased year by year. Reposted elsewhere in the paper for free download http://
3.1.2 obstetric goal is to mother and child safety, the implementation of this goal is
not only lies in how to give birth is more important is prenatal health care. Identification and treatment of high-risk pregnancy, cesarean section rate increased, so
that obstetricians deal with childbirth and reduced ability to vaginal delivery. Breech
delivery and in the past, low forceps, fetal head aspiration during cesarean section has gradually been replaced by the passage of time caused by obstetricians deal with childbirth and the ability to vaginal delivery becoming less and less, resulting in a
3.2 Human Factors
At present, most people from birth to ensure maternal and child safety requirements to ensure safe motherhood, under the premise to give priority to the child's "quality" problem. The current indications for cesarean section has far
exceeded the scope of purely medical indications, socio-economic and cultural
background and behavior patterns of doctors affects a reasonable choice of delivery methods.
3.2.1 maternal factor of contemporary young mothers and their fear of pain, in the birth process has been launched, there is no any risk factors have been identified is entirely possible for the case of vaginal delivery can not continue to endure the pains of childbirth, and the family do not want to anxiously wait, insist cesarean section, or even mistaken for a cesarean section safer than natural births. Split of natural products for fear the impact of maternal figure, lateral scar left behind after worried by the relaxation of vaginal delivery to the birth canal, affecting the future of a harmonious sexual life to choose cesarean section. Studies have shown that mode of delivery and there is no direct impact on sexual life, will not affect the quality of sexual life (except for multiple births).
3.2.2 prenatal and postnatal care to mothers and their families desire to not let the fetus have the slightest risk of perinatal hypoxia and birth trauma, and even some people mistakenly believe that their children smarter cesarean section. In the absence
of extrusion by the birth canal, the first type pretty. And more people choose to select the lucky date cesarean section, so that the high cesarean section rate is not
The next, so that neonatal pneumonia, hyperactivity, feeling a comprehensive
disorders, poor motor coordination increased risk, could easily lead to relatively poor immunity in the future.
3.2.3 Medical factors that ? the source of the increased year by year due to medical disputes brought more troubles to doctors and patients implementation of the right of
informed consent, the doctor at the maternity hospital when the mother is required to explain the pros and cons vaginal trial production, many mothers worry about Vaginal pilot failed even cesarean section, instead of by "growing of two crimes" not as direct selection operation, a "profile control" over. ? As the legal awareness and advocacy
awareness birth with the lack of high-risk nature of knowledge, so that the imbalance
between doctors and patients, the work of obstetricians lack strong legal protection, so that doctors worry that refusing to implement the procedure, adhere to vaginal childbirth accident, the disputes difficult to bear the consequences. ? Since doctors are
responsible desalination, and even some doctors due to cesarean section skilled, can be closed within a short time delivery, eliminating the need for health care workers observed a long time of hard labor and trouble. In the absence of entering an active phase before the premature failure of the pilot to confirm, choose cesarean section. In fact, some relative cephalopelvic disproportion, abnormal head posture of those cases are in the birth process can be actively converted to natural delivery. Thus, the lack of
rational and effective health care within the system of social security system, patient lack of mutual understanding and mutual trust interaction, but also increasing
cesarean section rate is currently a major reason.
Cesarean section rate increased to a certain extent, reflects the advances in
medical technology and people's cultural quality. As a means of treatment of dystocia, did play a significant role in saving the lives of many critically ill pregnant women. Within a certain range reduces the perinatal mortality rate, however, vaginal delivery is a natural physiological process of human history has proven that meet the physical standards and the laws of natural physiological processes. Cesarean section is only a kind of midwifery, surgery, to measure its value the information required from an objective, scientific analysis of the pros and cons and near its long-term prognosis.
Excessive cesarean section so that mother and child increased in recent long-term
morbidity, maternal and perinatal mortality rate can not be decreased, but somewhat
higher. China's current rate is higher than a reasonable rate of caesarean section, which requires the whole community to work together to create an environment conducive to rational choice of delivery methods in the social environment, strict
control indications for cesarean section, cesarean section to maximize the maximum extent, to play the role of cesarean section dealing with difficult birth.
 Li Fu. Affecting cesarean section rates and indications for cesarean section factors [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2003,19 (7): 405. Reposted elsewhere in the paper for free download http://