Obed Jy, Bako Bg, Agida Te, Nwobodo Ei
J West Afr Coll Surg. 2013 Jan;3(1):72-83.
Caesarean Delivery on Maternal Request (CDMR) is increasingly seen as a viable option to vaginal delivery even in the absence of medical or obstetric contraindications to vaginal delivery.
Self administered questionnaires were instituted to Senior Consultant Obstetricians attending the examiners' meeting of the faculty of obstetrics and gynaecology of the West African College of Surgeon in Ibadan, Nigeria on 17(th) April, 2013 and 23(th) October, 2013. This was to assess their experience and attitudes toward CDMR. The data were analysed with SPSS version 16.0 RESULTS: The majority of the consultants, 94.4%(85/90) have had antenatal client(s) ask for CDMR and 81.2%(69/85) of them have operated on at least a patient for CDMR. The reasons for the CDMR were: precious pregnancy/infertility, previous traumatic delivery and to avoid the stress of labour in 33%, 20.7% and 16.2% respectively. Eighty percent(68/85) consultants have counseled the women but only 11.8%(10/85) of them have had their patients change their minds and opted for vaginal delivery. Eighty eight(97.8%) of the obstetricians sampled are aware of the FIGO stand on Caesarean section however, 80(88.9%) of them opined that it is important to accommodate the feelings of the women and offer CDMR for the respect of the patient's autonomy.
There are cases of CDMR in the West African sub region and increasing willingness of the consultants to oblige to the request. There is need to develop a treatment guidelines/protocols for CDMR that will suit our environment in order to avoid over burdening of the limited health resources.
即使在没有阴道分娩的医学或产科禁忌证的情况下，产妇要求剖宫产（CDMR）也越来越被视为阴道分娩的一种可行选择。
2013年4月17日和2013年10月23日，对参加尼日利亚伊巴丹西非外科医生学院妇产科考官会议的高级顾问产科医生进行了自填式问卷调查。目的是评估他们对CDMR的经验和态度。使用SPSS 16.0版对数据进行分析。结果：大多数顾问（94.4%，85/90）有产前客户要求CDMR，其中81.2%（69/85）至少为一名CDMR患者实施了手术。CDMR的原因分别为：珍贵妊娠/不孕、既往创伤性分娩以及避免分娩压力，分别占33%、20.7%和16.2%。80%（68/85）的顾问对女性进行了咨询，但只有11.8%（10/85）的患者改变主意并选择了阴道分娩。抽样的产科医生中有88名（97.8%）了解国际妇产科联合会关于剖宫产的立场，然而，其中80名（88.9%）认为考虑女性的感受并提供CDMR以尊重患者自主权很重要。
在西非次区域存在CDMR病例，并且顾问们越来越愿意满足这一要求。有必要制定适合我们环境的CDMR治疗指南/方案，以避免有限的卫生资源负担过重。
