Sangalli Michel, Guidera Alice
Consultant Obstetrician and Gynaecologist, Women's Health Service, Wellington Hospital, Wellington South, New Zealand.
N Z Med J. 2004 Nov 26;117(1206):U1184.
The aims of this audit were to determine the frequency of caesarean section (CS) in the Wellington region for term nulliparous women, to evaluate the local demographic and clinical factors associated with CS, and to assess the quality of clinical care.
Nulliparous women with singleton live pregnancies and a gestational age greater than and equal to 36 weeks who had a CS in Wellington Hospital during 1 January 2001 to 30 June 2001 were identified using a computerised database. The Hospital records were reviewed. Demographic and clinical factors associated with CS were analysed and assessed against standards from the literature.
A total of 743 women with a singleton live pregnancy greater than and equal to 36 weeks delivered during the period. 209 women met the criteria and 201 files were available. The estimated corrected CS rate was 27%. Thirty-six women (5%, 36/743) had an elective CS, and 165 (22%, 165/743) had an emergency CS. Dystocia (48%), suspected fetal compromise (23%), and malpresentation (20%) represented the most common indications for CS. A significant proportion of CS were performed without meeting the standards.
In term nulliparous women, the indications for CS and the compliance with recognised standards from the literature were very similar to those observed in other industrialised countries.
本次审核的目的是确定惠灵顿地区足月未产妇的剖宫产（CS）发生率，评估与剖宫产相关的当地人口统计学和临床因素，并评估临床护理质量。
使用计算机数据库识别出2001年1月1日至2001年6月30日期间在惠灵顿医院进行剖宫产的单胎活产、孕周大于或等于36周的未产妇。查阅医院记录。分析与剖宫产相关的人口统计学和临床因素，并对照文献标准进行评估。
在此期间，共有743名单胎活产且孕周大于或等于36周的妇女分娩。209名妇女符合标准，获得了201份档案。估计校正后的剖宫产率为27%。36名妇女（5%，36/743）进行了择期剖宫产，165名妇女（22%，165/743）进行了急诊剖宫产。难产（48%）、疑似胎儿窘迫（23%）和胎位异常（20%）是剖宫产最常见的指征。很大一部分剖宫产手术未达标准。
在足月未产妇中，剖宫产指征和符合文献公认标准的情况与其他工业化国家观察到的情况非常相似。
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