Chhabra S, Jaiswal A, Raman S
Department of Obstetrics and Gynaecology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India.
J Obstet Gynaecol. 2009 Nov;29(8):718-21. doi: 10.3109/01443610903195286.
Caesarean section is one of the commonest major surgical procedures in public and private hospitals. The worldwide rise in the caesarean section rate during the last 50 years is cause for alarm and a matter of concern. This increase deserves international attention not only because of health consequences, resource administration and policies, but also because high caesarean section rates are not associated with low perinatal mortality rates. The present study is an analysis of indications of caesarean sections performed with no take-home baby ('fruitless' caesarean section) between April 1983 and March 2007. It was revealed that the caesarean section rate has increased from 15.47% of births in 1983 to 37.96% births in 2007, and 03.75% of these were fruitless. The overall perinatal mortality rate has reduced from 91.56 in 1983 to 51.20 in 2007, for various reasons. This analysis reveals a large increase in caesarean sections with many being fruitless. While the major causes of perinatal mortality were sepsis, prematurity and congenital anomalies which need to be addressed, it is also essential to review the indications of caesarean section, so as to prevent fruitless caesarean sections.
剖宫产是公立和私立医院中最常见的大型外科手术之一。在过去50年里，全球剖宫产率的上升令人担忧，值得关注。这一增长值得国际关注，不仅是因为其对健康的影响、资源管理和政策，还因为高剖宫产率与低围产期死亡率并无关联。本研究分析了1983年4月至2007年3月期间无活产婴儿的剖宫产（“无果”剖宫产）指征。结果显示，剖宫产率从1983年占分娩总数的15.47%上升至2007年的37.96%，其中3.75%为无果剖宫产。由于各种原因，总体围产期死亡率已从1983年的91.56降至2007年的51.20。该分析表明剖宫产大幅增加，其中许多是无果的。虽然围产期死亡的主要原因是败血症、早产和先天性异常，这些需要加以解决，但审查剖宫产指征也至关重要，以防止无果剖宫产。
