Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Semin Perinatol. 2012 Oct;36(5):399-402. doi: 10.1053/j.semperi.2012.04.027.
As the cesarean delivery rate has increased to once unimaginable levels, obstetricians should question the loss of our credibility. Older mothers, obesity, larger birth weights, too many twins, and no more breech vaginal deliveries have all been cited as contributing factors to the increase in primary cesarean birth, but one cannot neglect the influence of physician practice style. Attempts to curtail or reverse the escalating incidence of primary abdominal deliveries should focus on caution with inductions of labor, patience with the management of arrest disorders, more accurate assessment of fetal compromise, patient education and informed decision making about the benefits/risks of operative delivery, and improvement in the medicolegal environment.
随着剖宫产率上升到了以往难以想象的水平，产科医生应该质疑我们失去了信誉。高龄产妇、肥胖、更大的出生体重、太多的双胞胎，以及不再进行臀位阴道分娩，这些都被认为是导致初次剖宫产率上升的因素，但不能忽视医生实践风格的影响。减少或逆转初次剖宫产发生率的上升，应该集中在对引产的谨慎处理、对产程停滞的管理有耐心、更准确地评估胎儿窘迫、对患者进行教育并使其了解手术分娩的利弊、以及改善医疗法律环境。
