当代美国的剖宫产实践。
Contemporary cesarean delivery practice in the United States.
机构信息
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
出版信息
Am J Obstet Gynecol. 2010 Oct;203(4):326.e1-326.e10. doi: 10.1016/j.ajog.2010.06.058. Epub 2010 Aug 12.
Abstract
OBJECTIVE
To describe contemporary cesarean delivery practice in the United States.
STUDY DESIGN
Consortium on Safe Labor collected detailed labor and delivery information from 228,668 electronic medical records from 19 hospitals across the United States, 2002-2008.
RESULTS
The overall cesarean delivery rate was 30.5%. The 31.2% of nulliparous women were delivered by cesarean section. Prelabor repeat cesarean delivery due to a previous uterine scar contributed 30.9% of all cesarean sections. The 28.8% of women with a uterine scar had a trial of labor and the success rate was 57.1%. The 43.8% women attempting vaginal delivery had induction. Half of cesarean for dystocia in induced labor were performed before 6 cm of cervical dilation.
CONCLUSION
To decrease cesarean delivery rate in the United States, reducing primary cesarean delivery is the key. Increasing vaginal birth after previous cesarean rate is urgently needed. Cesarean section for dystocia should be avoided before the active phase is established, particularly in nulliparous women and in induced labor.
摘要
目的
描述美国当代剖宫产的实践情况。
研究设计
安全分娩联合会从 2002 年至 2008 年期间，在美国 19 所医院的 228668 份电子病历中收集了详细的分娩和分娩信息。
结果
总体剖宫产率为 30.5%。31.2%的初产妇行剖宫产术分娩。由于先前的子宫疤痕而进行的产前重复剖宫产术占所有剖宫产术的 30.9%。28.8%有子宫疤痕的妇女尝试了阴道分娩，成功率为 57.1%。43.8%尝试阴道分娩的妇女接受了引产。在宫颈扩张达到 6 厘米之前，半数因产程中出现困难而进行的剖宫产术在活跃期之前进行。
结论
为了降低美国的剖宫产率，减少初次剖宫产是关键。迫切需要增加前次剖宫产术后阴道分娩率。对于产程中出现困难的剖宫产术，应避免在活跃期建立之前进行，尤其是对于初产妇和引产妇女。
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