Department of Obstetrics and Gynaecology, Ghent University Hospital, Belgium.
BMC Pregnancy Childbirth. 2012 Jan 9;12:3. doi: 10.1186/1471-2393-12-3.
As the rate of Caesarean sections (CS) continues to rise in Western countries, it is important to analyze the reasons for this trend and to unravel the underlying motives to perform CS. This research aims to assess the incidence and trend of CS in a population-based birth register in order to identify patient groups with an increasing risk for CS.
Data from the Flemish birth register 'Study Centre for Perinatal Epidemiology' (SPE) were used for this historic control comparison. Caesarean sections (CS) from the year 2000 (N = 10540) were compared with those from the year 2008 (N = 14016). By means of the Robson classification, births by Caesarean section were ordered in 10 groups according to mother - and delivery characteristics.
Over a period of eight years, the CS rise is most prominent in women with previous sections and in nulliparous women with a term cephalic in spontaneous labor. The proportion of inductions of labor decreases in favor of elective CS, while the ongoing inductions of labor more often end in non-elective CS.
In order to turn back the current CS trend, we should focus on low-risk primiparae. Avoiding unnecessary abdominal deliveries in this group will also have a long-term effect, in that the number of repeat CS will be reduced in the future. For the purpose of self-evaluation, peer discussion on the necessity of CS, as well as accurate registration of the main indication for CS are recommended.
在西方国家，剖宫产率持续上升，因此分析这一趋势的原因并揭示行剖宫产的潜在动机非常重要。本研究旨在评估基于人群的出生登记处的剖宫产率的发生率和趋势，以确定剖宫产风险增加的患者群体。
本研究使用了弗拉芒出生登记处“围产期流行病学研究中心”（SPE）的数据进行历史对照比较。将 2000 年（N=10540）和 2008 年（N=14016）的剖宫产术进行比较。通过 Robson 分类，根据母亲和分娩特征将剖宫产术分娩分为 10 组。
在八年期间，既往剖宫产和自发性分娩足月头位的初产妇的剖宫产率上升最为明显。催产的比例下降，有利于选择性剖宫产，而正在进行的催产更常导致非选择性剖宫产。
为了扭转当前的剖宫产趋势，我们应重点关注低风险的初产妇。避免在该人群中进行不必要的腹部分娩也将产生长期影响，因为未来重复剖宫产的数量将会减少。为了进行自我评估、同行讨论剖宫产的必要性以及准确记录主要剖宫产指征，建议进行上述操作。
