Dresang Lee T, Leeman Lawrence
Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, 1100 Delaplaine Ct, Madison, WI 53715, USA.
Prim Care. 2012 Mar;39(1):145-65. doi: 10.1016/j.pop.2011.11.007.
Cesarean delivery rates rose from 20 to 33% of births in the United States from 2006-2009 without an accompanying improvement in neonatal outcomes. The cesarean rate may be safely decreased by increasing vaginal birth after cesarean, encouraging external cephalic version for breech presentation, maintaining operative vaginal delivery skills, and applying stricter criteria for operative intervention in labor dystocia. A variety of cesarean operative techniques are supported by randomized controlled trials. Optimal maternity care outcomes depend on sound medical decision-making, appropriate operative technique and skills, and effective communication between maternity care team members.
2006年至2009年期间，美国剖宫产率从分娩总数的20%升至33%，但新生儿结局并未随之改善。通过增加剖宫产术后阴道分娩、鼓励对臀位进行外倒转术、保持阴道助产技能以及对产程延长的手术干预采用更严格的标准，可以安全地降低剖宫产率。随机对照试验支持多种剖宫产手术技术。最佳的孕产妇护理结局取决于合理的医疗决策、恰当的手术技术和技能，以及孕产妇护理团队成员之间的有效沟通。
