2014-2020 年东莞市某三级医院流动人口产妇剖宫产率及剖宫产指征分析

Analysis of cesarean section rate and indications of pregnant women of floating population in a tertiary hospital in Dongguan city from 2014 to 2020

摘要:

摘 要：目的 分析东莞市某三级医院 2014-2020 年流动人口产妇剖宫产率及剖宫产指征变化情况。方法 收集 2014-2020 年东莞市某三级甲等医院住院分娩流动人口产妇的临床资料，剖宫产指征以第一指征为主，对其剖宫产指征 构成及其变化进行回顾性分析。结果 该组孕产妇 32 401 例，剖宫产 8 721 例，剖宫产率为 26.9%。2014-2020 年各年份 的剖宫产率分别为 29.8%、25.2%、26.6%、26.3%、25.1%、28.0%、27.1%。剖宫产指征以瘢痕子宫居首位，其他依次为胎 位异常、胎儿宫内窘迫和社会因素。在高龄、非高龄产妇剖宫产指征中，瘢痕子宫和胎位异常均分别位居第 1、2 位，第 3 位剖宫产指征分别为产妇要求和胎儿宫内窘迫；高龄产妇的瘢痕子宫、前置胎盘、妊娠合并症、妊娠合并肿瘤构成比等均 高于非高龄产妇，胎位异常、胎儿宫内窘迫、羊水过少、产程异常的比例则低于非高龄产妇（P<0.05）。结论 该研究的剖 宫产率仍高于WHO标准，剖宫产指征中以瘢痕子宫和胎位异常为主。

Abstract:

Abstract: Objective To analyze the changes of cesarean section rate and indications of pregnant women of floating population in a tertiary hospitals in Dongguan city. Methods The clinical data of floating postpartum women were collected, who were hospitalized and delivered in tertiary hospital from 2014 to 2020 in Dongguan city, and the composition and changes of cesarean section indicators were considered as the first indication and retrospective analysiswere conducted. Results The total number of pregnant women in this study was 32 401, including 8 721 cases of cesarean section, and the cesarean section rate was 26.9%. The cesarean section rates for each year from 2014 to 2020 were 29.8%, 25.2%, 26.6%, 26.3%, 25.1%, 28.0%, and 27.1%, respectively. The indications for cesarean section was primarily scar uterus, followed by abnormal fetal position, fetal distress, and social factors. Among the indications for cesarean section in elderly and non elderly maternal, the scar uterus and abnormal fetal position were ranked first and second, respectively. The third indication for cesarean section was maternal requirements and fetal distress in the uterus, respectively. The proportions of scar uterus, placenta previa and severe complications of pregnancy in the advanced maternal age were higher than those in non elderly maternal, while the proportions of abnormal labor process, fetal distress and oligohydramnios in non elderly maternal were higher than those in the advanced maternal age (P<0.05). Conclusion The cesarean section rate in this study is still higher than WHO standards, and the indications for cesarean section are mainly scar uterus and abnormal fetal position.