剖宫产率的变化作为当前医疗事故危机的一种反映。

Change in cesarean section rate as a reflection of the present malpractice crisis.

作者信息

Ryan Kristi, Schnatz Peter, Greene John, Curry Stephen

机构信息

Department of OB/GYN, University of Connecticut School of Medicine, Hartford, USA.

出版信息

Conn Med. 2005 Mar;69(3):139-41.

PMID:15861999

Abstract

OBJECTIVE

To examine the potential effect of the malpractice crisis on the cesarean section rates of practicing obstetricians.

METHODS

We reviewed the medical records of primagravid women, from both clinic and private practice settings, having singleton deliveries at Hartford Hospital from 1994 to 2003. The records of cesarean sections due to fetal distress and cephalopelvic disproportion (CPD) were further analyzed for three different two-year periods; 1994-1995, 1999-2000, and 2002-2003. Cases with accepted indications for elective cesarean sections were excluded. These included breech position, HIV, herpes, preeclampsia, placenta previa, and abruptio placenta.

RESULTS

The private cesarean rate in 1994-1995 was 15.6%, 1999-2000 15.7%, and in 2002-2003 24.8%, a 58% increase. This is a significant increase that was not equally seen in the clinic population during the same period.

CONCLUSION

The private, primagravid cesarean section rate has increased significantly in the last two years. A concurrent rise in medical malpractice actions and malpractice insurance premiums, without other attributable explanations, suggests this may be a major factor.

摘要

目的

探讨医疗事故危机对执业产科医生剖宫产率的潜在影响。

方法

我们回顾了1994年至2003年在哈特福德医院进行单胎分娩的初产妇的病历，这些产妇来自诊所和私人执业机构。对1994 - 1995年、1999 - 2000年和2002 - 2003年这三个不同的两年期间因胎儿窘迫和头盆不称（CPD）而进行剖宫产的记录进行了进一步分析。排除有选择性剖宫产公认指征的病例。这些指征包括臀位、艾滋病毒、疱疹、先兆子痫、前置胎盘和胎盘早剥。