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剖宫产:合理指征还是合理担忧?

[Cesarean birth: justifying indication or justified concern?].

作者信息

Muñoz-Enciso José Manuel, Rosales-Aujang Enrique, Domínguez-Ponce Guillermo, Serrano-Díaz César Leopoldo

机构信息

Departamento de Ginecología y Obstetricia, Hospital General, ISSSTE.

出版信息

Ginecol Obstet Mex. 2011 Feb;79(2):67-74.

Abstract

BACKGROUND

Caesarean section is the most common surgery performed in all hospitals of second level of care in the health sector and more frequently in private hospitals in Mexico.

OBJECTIVE

To determine the behavior that caesarean section in different hospitals in the health sector in the city of Aguascalientes and analyze the indications during the same period.

MATERIAL AND METHOD

A descriptive and cross in the top four secondary hospitals in the health sector of the state of Aguascalientes, which together account for 81% of obstetric care in the state, from 1 September to 31 October 2008. Were analyzed: indication of cesarean section and their classification, previous pregnancies, marital status, gestational age, weight and minute Apgar newborn and given birth control during the event.

RESULTS

were recorded during the study period, 2.964 pregnancies after 29 weeks, of whom 1.195 were resolved by Caesarean section with an overall rate of 40.3%. We found 45 different indications, which undoubtedly reflect the great diversity of views on the institutional medical staff to schedule a cesarean section.

CONCLUSIONS

Although each institution has different resources and a population with different characteristics, treatment protocols should be developed by staff of each hospital to have the test as a cornerstone of labor, also request a second opinion before a caesarean section, all try to reduce the frequency of cesarean section.

摘要

背景

剖宫产是卫生部门二级医疗机构中最常见的手术,在墨西哥的私立医院中更为频繁。

目的

确定阿瓜斯卡连特斯市卫生部门不同医院剖宫产的情况,并分析同一时期的手术指征。

材料与方法

对阿瓜斯卡连特斯州卫生部门排名前四的二级医院进行描述性和交叉性研究,这些医院占该州产科护理的81%,研究时间为2008年9月1日至10月31日。分析内容包括:剖宫产指征及其分类、既往妊娠情况、婚姻状况、孕周、新生儿体重和阿氏评分,以及分娩期间的避孕措施。

结果

在研究期间记录了29周后的2964例妊娠,其中1195例通过剖宫产分娩,总体剖宫产率为40.3%。我们发现了45种不同的指征,这无疑反映了医疗机构医务人员在安排剖宫产时观点的巨大差异。

结论

尽管每个机构的资源不同,人群特征各异,但每家医院的工作人员都应制定治疗方案,将试产作为分娩的基石,在剖宫产术前征求第二意见,努力降低剖宫产率。

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