Trujillo-Hernández B, Rios-Silva M, Huerta M, Trujillo X, Vásquez C, Millán-Guerrero R
Unidad de Investigación en Epidemiología Clínica, Hospital General de Zona y Medicina Familiar No. 1 Colima, Col., Calle Colibrí # 65, Colonia Colinas de Santa Bárbara, Colima, Colima México, CP 28020.
Arch Gynecol Obstet. 2002 Nov;267(1):27-32. doi: 10.1007/s00404-001-0255-6.
The aim of this study was to determine the frequency of, indications for and clinical epidemiological characteristics in patients having their first cesarean section (FCS) and then to compare the data with that found in patients with repeated cesarean section (RCS).
A cross-sectional study was carried out. 493 pregnant patients who gave birth by cesarean section or vaginal delivery were seen. Some of the variables analyzed were: age, prenatal care consultations, gyneco-obstetric antecedents, cesarean section indication and neonate weight. Statistical analysis included ANOVA, chi(2) and OR, with a 95% CI. Significance was p<0.05.
66% of the patients had vaginal births (VB) and 33.4% had cesarean sections, with a FCS frequency of 61%. The three most frequent indications for FCS were dystocias and cephalopelvic disproportion (45%), fetal distress (12.8%), and pelvic presentation (9.9%). Meanwhile, those for RCS were previous cesarean section (51%), dystocias (20%) and pelvic presentation (6.2%). The variables significantly associated with FCS were: first pregnancy, antecedent of labor room induction and a neonate weight above 3500 g. The remaining variables were not associated with FCS. Percentages of nulliparity, secondgravidity and multigravidity were greater in RCS patients.
The frequency of FCS is still high in Mexico. Adequate following of programs to diminish the percentage of FCS and increase the number of VB, would significantly reduce the prevalence of cesarean section.
本研究旨在确定首次剖宫产（FCS）患者的频率、指征及临床流行病学特征，然后将数据与重复剖宫产（RCS）患者的数据进行比较。
开展了一项横断面研究。观察了493例通过剖宫产或阴道分娩的孕妇。分析的一些变量包括：年龄、产前检查次数、妇产科病史、剖宫产指征及新生儿体重。统计分析包括方差分析、卡方检验和比值比（OR），置信区间为95%。显著性水平为p<0.05。
66%的患者为阴道分娩（VB），33.4%为剖宫产，FCS频率为61%。FCS最常见的三个指征是难产和头盆不称（45%）、胎儿窘迫（12.8%）和胎位异常（9.9%）。同时，RCS的指征是既往剖宫产（51%）、难产（20%）和胎位异常（6.2%）。与FCS显著相关的变量有：初孕、产房引产史和新生儿体重超过3500g。其余变量与FCS无关。RCS患者中初产妇、经产妇和多产妇的比例更高。
在墨西哥，FCS的频率仍然很高。充分落实相关项目以降低FCS的比例并增加VB的数量，将显著降低剖宫产的患病率。
