Choudhury A P, Dawson A J
Department of Obstetrics and Gynaecology, Nevill Hall Hospital, Abergavenny, UK.
J Obstet Gynaecol. 2009 Nov;29(8):714-7. doi: 10.3109/01443610903191269.
The National Sentinel Caesarean Section (CS) Audit showed that the overall CS rate was 21.5% in England and Wales. There have been concerns about the rising CS rate in the UK. We reviewed whether there were any changes in indications for CS over 7 years (2001-2007) in our district general hospital. A database was written and used to record data about each CS, electronically. A library of entries was used to record the indications for all caesarean sections. The data were analysed by each of the years from 2001 to 2007. The overall CS rate in the hospital was nearly 30% in 2007, a rise from 26% in 2001. The commonest indication was previous single CS, followed by other indications: failure-to-progress during the first stage of labour, fetal distress and breech presentation. Over the 7-year period, we have been unable to show any real change in the proportions of indications for CS. Despite heightened awareness and regular feedback, there has been no detectable reduction in CS rates. They appear instead to have increased with no change in the proportions of indications.
国家剖宫产监测审计显示，在英格兰和威尔士，剖宫产的总体比率为21.5%。英国剖宫产率不断上升，引发了人们的担忧。我们回顾了我们地区综合医院在7年（2001 - 2007年）间剖宫产指征是否有任何变化。编写了一个数据库，并用于以电子方式记录每例剖宫产的数据。使用一个条目库来记录所有剖宫产的指征。对2001年至2007年每年的数据进行了分析。2007年该医院的总体剖宫产率接近30%，高于2001年的26%。最常见的指征是既往单次剖宫产，其次是其他指征：第一产程进展受阻、胎儿窘迫和臀位。在这7年期间，我们未能发现剖宫产指征比例有任何实际变化。尽管提高了认识并定期提供反馈，但剖宫产率并未出现可检测到的下降。相反，剖宫产率似乎有所上升，而指征比例却没有变化。
