Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, National University Health Systems and National University of Singapore, Level 12, NUHS Tower Block, 1E Kent Ridge Road, Singapore 119228, Singapore.
Best Pract Res Clin Obstet Gynaecol. 2013 Apr;27(2):209-19. doi: 10.1016/j.bpobgyn.2012.09.002. Epub 2012 Oct 10.
Caesarean section incidence is steadily rising worldwide; the major contributor to this rise is pregnancies with previous caesarean section. Hence, it is important to scrutinise carefully the indication of primary caesarean sections. Preterm births, breech presentation and twin pregnancies together complicate 12-18% of all births. The role of caesarean section in these pregnancies is controversial and lacks good evidence-based guidelines. Policy on mode of delivery in these three important obstetric groups is bound to influence overall primary caesarean section rates. In this chapter, we review the evidence on the place of caesarean delivery in these three important groups.
剖宫产率在全球范围内呈稳步上升趋势;导致这一上升的主要原因是既往剖宫产的孕妇再次妊娠。因此,仔细审查首次剖宫产的适应证非常重要。早产、臀位和双胎妊娠共同使所有分娩的 12%-18%变得复杂。在这些妊娠中,剖宫产的作用存在争议,且缺乏良好的基于证据的指南。这三个重要产科群体的分娩方式政策必然会影响整体首次剖宫产率。在本章中,我们回顾了这些重要群体中剖宫产应用的证据。