Amatya A, Paudel R, Poudyal A, Wagle R R, Singh M, Thapa S
Department of Community Medicine and Public Health, Tribhuvan University Teaching Hospital, Institute of Medicine, Nepal.
Department of Obstetrics and Gynecology, Tribhuvan University Teaching Hospital, Institute of Medicine, Nepal.
J Nepal Health Res Counc. 2013 Sep;11(25):255-8.
Caesarean section rates have been increasing worldwide over the past few decades, with most countries and regions exceeding the World Health Organization recommended rate of 15% of all deliveries.
This study was carried out with the objective of reviewing the rates of cesarean sections over five years (2005-2010) and to assess the stratified rates of cesarean sections for audit of intrapartum management in University Teaching Hospital, Institute of Medicine. Data was stratified into 10 mutually exclusive groups, by using the method presented by Michael Robson.
A total of 5907 women had under gone caeserean section over a period of five years. The results showed a growing trend of cesarean section rate from 16.6% to 25.4%. The results of this analysis using the Robson classification has shown that group 1(Nulliparous, single cephalic ≥ 37 weeks gestation in spontaneous labour) has the largest number of cesarean deliveries followed by group 3(Multiparous, single cephalic ≥37 weeks gestation in spontaneous labor, no previous CS), although Robson classification showed that group 5 was the biggest contributor.
The growing and uniform distribution (throughout the year) of cesarean section has been observed for five years. This analysis provides evidence-based data so we can analyze where to aim our preventive measures and focus efforts in reducing the rate of CS. We would like to suggest that all hospitals and health authorities apply this standardized classification system as to monitor their CS rates and find ways to reduce it, and improve quality care.
在过去几十年里，全球剖宫产率一直在上升，大多数国家和地区都超过了世界卫生组织建议的占所有分娩15%的比率。
本研究旨在回顾五年（2005 - 2010年）间的剖宫产率，并评估医学院大学教学医院用于产时管理审计的分层剖宫产率。数据采用迈克尔·罗布森提出的方法分为10个相互排斥的组。
在五年期间共有5907名妇女接受了剖宫产。结果显示剖宫产率呈上升趋势，从16.6%升至25.4%。使用罗布森分类法的分析结果表明，第1组（初产妇，单头位≥37周妊娠，自然分娩）剖宫产分娩数量最多，其次是第3组（经产妇，单头位≥37周妊娠，自然分娩，既往无剖宫产史），尽管罗布森分类显示第5组是最大贡献者。
五年间观察到剖宫产率呈上升且全年分布均匀的情况。该分析提供了循证数据，以便我们能够分析应将预防措施的目标指向何处，并集中精力降低剖宫产率。我们建议所有医院和卫生当局应用这种标准化分类系统来监测其剖宫产率，并找到降低该比率及改善优质护理的方法。
