Chigbu C O, Iloabachie G C
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
BJOG. 2007 Oct;114(10):1261-5. doi: 10.1111/j.1471-0528.2007.01440.x.
To investigate the prevalence, aetiology and outcomes of caesarean section refusal in pregnant women.
A prospective controlled study.
University of Nigeria Teaching Hospital and Aghaeze Hospital, Enugu, Nigeria.
A total of 62 Nigerian women who declined elective caesarean section.
Interviewer-administered questionnaires at the time of caesarean section refusal and postdelivery. The delivery outcomes of the subjects were compared with that of a matched control group of women who accepted caesarean section.
Prevalence, maternal reasons for caesarean section refusal and the resultant maternal and perinatal mortality.
The prevalence of caesarean section refusal was 11.6% of all caesarean deliveries. Maternal reasons for refusing caesarean section include fear of death, economic reasons, desire to experience vaginal delivery and inadequate counselling. Outcomes were significantly worse among women who refused elective caesarean section than in the controls with a maternal mortality of 15% (versus 2%, P = 0.008) and a perinatal mortality of 34% (versus 5%, P < 0.001).
There is a high prevalence of caesarean section refusal in south-eastern Nigeria. Women declining caesareans have very poor maternal and perinatal outcomes and need extra support.
调查孕妇拒绝剖宫产的发生率、病因及结局。
一项前瞻性对照研究。
尼日利亚埃努古的尼日利亚大学教学医院和阿加埃泽医院。
共有62名拒绝择期剖宫产的尼日利亚妇女。
在拒绝剖宫产时及产后由访员进行问卷调查。将研究对象的分娩结局与接受剖宫产的匹配对照组妇女的结局进行比较。
发生率、产妇拒绝剖宫产的原因以及由此导致的孕产妇和围产儿死亡率。
拒绝剖宫产的发生率占所有剖宫产分娩的11.6%。产妇拒绝剖宫产的原因包括怕死、经济原因、希望体验阴道分娩以及咨询不足。拒绝择期剖宫产的妇女结局明显比对照组差，孕产妇死亡率为15%（对照组为2%，P = 0.008），围产儿死亡率为34%（对照组为5%，P < 0.001）。
尼日利亚东南部拒绝剖宫产的发生率很高。拒绝剖宫产的妇女孕产妇和围产儿结局非常差，需要额外的支持。
