Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS K-23, Atlanta, GA 30341, USA.
Matern Child Health J. 2012 Oct;16(7):1484-90. doi: 10.1007/s10995-011-0913-7.
This study investigated changes in cesarean delivery rate and cesarean indications in 3 county-level hospitals in rural China. Hospital delivery records in 1997 and 2003 were used to examine the reasons behind the changes. In Chengde County Hospital, the cesarean delivery rate increased from 28% in 1997 to 54% in 2003. The rate increased from 43% in 1997 to 65% in 2003 in Anxian County Hospital and Anxian Maternal and Child Health Hospital. The dramatic increase in cesarean delivery in the study hospitals was associated with a shift from more severe to mild or no clinical indications. The ratio of mild to moderate to severe hypertension increased substantially. More than half of the cephalopelvic disproportion cases were diagnosed prior to labor. The majority of nuchal cord cases were diagnosed without fetal distress. Maternal/family request was the number one cesarean indication in Anxian County Hospital and Anxian MCH Hospital in 2003. Ultrasound evidence of nuchal cord moved from the ninth ranked indication in 1997 to the second in 2003 in Chengde County Hospital.
本研究调查了中国农村 3 家县级医院剖宫产率和剖宫产指征的变化。利用 1997 年和 2003 年的医院分娩记录，考察了这些变化的原因。在承德县医院，剖宫产率从 1997 年的 28%上升到 2003 年的 54%。在安贤县医院和安贤县妇幼保健院，剖宫产率从 1997 年的 43%上升到 2003 年的 65%。研究医院剖宫产率的急剧上升与临床指征从轻到无的转变有关。轻度至中度高血压的比例大幅增加。超过一半的头盆不称病例是在分娩前诊断的。大多数脐带绕颈病例是在没有胎儿窘迫的情况下诊断的。在 2003 年，产妇/家属要求是安贤县医院和安贤县妇幼保健院剖宫产的首要指征。承德县医院的超声证据显示，脐带绕颈的指征从 1997 年的第九位上升到 2003 年的第二位。
