Saunders L D, Flowerdew G
Department of Health Services Administration and Community Medicine, University of Alberta, Edmonton.
CMAJ. 1991 May 15;144(10):1243-9, 1252.
To determine (a) trends in the cesarean section rate in Alberta from April 1979 to March 1988, (b) the contribution of different primary indications to the overall increase in the cesarean section rate and (c) trends in the cesarean section rate by residence of the mother.
Retrospective study.
Women who gave birth in acute care hospitals in Alberta during the study period. Indications for cesarean section were defined by a hierarchic classification system. Geographic regions were identified according to the mother's residence.
The crude cesarean section rate increased from 13.2 to 17.3 per 100 deliveries between 1979-80 and 1987-88. Previous cesarean section accounted for 54% of the increase, breech presentation for 17%, fetal distress for 17% and dystocia for 10%. The contribution of previous cesarean section was due to the substantial increase in the number of women presenting with a previous cesarean section. The cesarean section rate among women who had previously had the procedure decreased from 96.7% in 1979-80 to 84.6% in 1987-88. The crude cesarean section rates by region varied from 10.3 to 22.3 per 100 deliveries.
Further efforts to reduce the rate of cesarean section among women who have previously undergone the procedure are needed to control the rate of cesarean section in Alberta. Decreasing the rate of primary cesarean section is also an important goal.
确定 (a) 1979年4月至1988年3月艾伯塔省剖宫产率的趋势；(b) 不同主要指征对剖宫产率总体上升的贡献；(c) 按母亲居住地划分的剖宫产率趋势。
回顾性研究。
研究期间在艾伯塔省急症医院分娩的妇女。剖宫产指征由一个分级分类系统定义。地理区域根据母亲的居住地确定。
1979 - 1980年至1987 - 1988年期间，剖宫产粗率从每100例分娩13.2例增至17.3例。既往剖宫产占增加量的54%，臀位占17%，胎儿窘迫占17%，难产占10%。既往剖宫产的贡献是由于有既往剖宫产史的妇女数量大幅增加。既往接受过剖宫产手术的妇女的剖宫产率从1979 - 1980年的96.7%降至1987 - 1988年的84.6%。各地区的剖宫产粗率从每100例分娩10.3例至22.3例不等。
需要进一步努力降低既往接受过剖宫产手术的妇女的剖宫产率，以控制艾伯塔省的剖宫产率。降低初次剖宫产率也是一个重要目标。
