Department of Woman and Child Health, Karolinska University Hospital, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2010;89(1):49-53. doi: 10.3109/00016340903418777.
The aim of this study was to investigate the indications for cesarean sections in the early 1990s as compared to the middle 2000s.
Retrospective cohort study.
Data were collected from original obstetrical records in a tertiary hospital in 1992 and 2005.
The total cesarean delivery rate rose from 11% to 20%. The main indications for an elective cesarean in 1992 were a pathological fetal lie or a uterine factor. The dominant indication for an elective cesarean in 2005 was a psychosocial indication defined as maternal fear of childbirth or maternal request without any co-existing medical indication. Presumed fetal compromise and prolonged labor remained the main indications for urgent and emergency cesareans. No apparent alterations in population characteristics could be identified for these years.
The increased rate of elective cesareans for psychosocial indications would reflect altered attitudes towards mode of delivery in the childbearing population and among obstetricians. We suggest that extended support from community antenatal care should be provided and that standardized keys aiding a physician in decision-making procedures concerning the cesarean section practice should be developed.
本研究旨在比较 20 世纪 90 年代初和 21 世纪初剖宫产的指征。
回顾性队列研究。
数据来自 1992 年和 2005 年在一家三级医院的原始产科记录。
总剖宫产率从 11%上升至 20%。1992 年选择性剖宫产的主要指征为病理性胎先露或子宫因素。2005 年选择性剖宫产的主要指征为社会心理因素，定义为产妇对分娩的恐惧或产妇无任何并存医学指征的要求。假定胎儿窘迫和产程延长仍然是紧急和紧急剖宫产的主要指征。这些年的人群特征似乎没有明显改变。
社会心理因素导致选择性剖宫产率增加，这反映了生育人群和产科医生对分娩方式的态度发生了变化。我们建议应提供社区产前保健的扩展支持，并制定有助于医生在剖宫产决策程序中做出决策的标准化关键指标。
