孟加拉国提供紧急产科护理的医院的剖宫产率。

Rate of cesarean delivery at hospitals providing emergency obstetric care in Bangladesh.

作者信息

Islam Mohammad T, Yoshimura Yukie

机构信息

Safe Motherhood Promotion Project, Japan International Cooperation Agency, Dhaka, Bangladesh.

出版信息

Int J Gynaecol Obstet. 2015 Jan;128(1):40-3. doi: 10.1016/j.ijgo.2014.07.021. Epub 2014 Aug 27.

DOI:10.1016/j.ijgo.2014.07.021

PMID:25257570

Abstract

OBJECTIVE

To assess the rate of cesarean delivery and its indications at public emergency obstetric care (EmOC) hospitals in a district in Bangladesh.

METHODS

In a retrospective, cross-sectional study, data were extracted from the Safe Motherhood Promotion Project database and operation theater registers for cesarean deliveries at three district and three subdistrict EmOC hospitals in Narsingdi between January 1 and December 31, 2008. Information on cesarean deliveries and their indications, and maternal and neonatal outcomes were analyzed descriptively.

RESULTS

Among 3329 deliveries, 1075 (32.3%) occurred by cesarean. The frequency of cesarean delivery ranged from 17.8% (147 of 824 deliveries) to 56.3% (174 of 309) among the six hospitals. Information on indications was available for 1043 cesarean deliveries. The main indications were previous cesarean delivery (251 deliveries, 24.1%), fetal distress (228, 21.9%), and prolonged or obstructed labor (214, 20.5%). There were no maternal deaths, but 10 (1.0%) cesarean deliveries resulted in stillbirth.

CONCLUSION

The overall rate of cesarean delivery was high at EmOC hospitals. Interventions to improve decision making and limit possible unnecessary cesarean operations are needed.

摘要

目的

评估孟加拉国某地区公立医院紧急产科护理（EmOC）机构的剖宫产率及其指征。

方法

在一项回顾性横断面研究中，从促进安全孕产项目数据库以及2008年1月1日至12月31日期间纳拉扬甘杰地区三家区级和三家分区级EmOC医院的剖宫产手术室登记册中提取数据。对剖宫产及其指征以及母婴结局的信息进行描述性分析。

结果

在3329例分娩中，1075例（32.3%）为剖宫产。六家医院的剖宫产率从17.8%（824例分娩中的147例）到56.3%（309例中的174例）不等。1043例剖宫产有指征信息。主要指征为既往剖宫产史（251例分娩，24.1%）、胎儿窘迫（228例，21.9%）以及产程延长或梗阻（214例，20.5%）。无孕产妇死亡，但10例（1.0%）剖宫产导致死产。