Groen Reinou S, Trelles Miguel, Caluwaerts Severine, Papillon-Smith Jessica, Noor Saiqa, Qudsia Burhani, Ndelema Brigitte, Kondo Kalla M, Wong Evan G, Patel Hiten D, Kushner Adam L
Surgeons OverSeas, New York, NY, USA; Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA.
Surgery, Anesthesia, Gynecology, and Emergency Medicine Unit, Médecins Sans Frontières (MSF), Operational Centre Brussels, Brussels, Belgium.
Int J Gynaecol Obstet. 2015 Jun;129(3):231-5. doi: 10.1016/j.ijgo.2014.12.008. Epub 2015 Feb 28.
To review the major indications for cesareans performed by Médecins Sans Frontières (MSF) personnel from the Operational Center Brussels.
A retrospective study was undertaken of all singleton cesarean deliveries from 2008-2012 for which indications were recorded. Location of project, age of patient, type of anesthesia, and duration of operation were also recorded.
A total of 14 151 singleton cesarean deliveries were identified from 17 countries. Among the 15 905 indications recorded, the most common was failure to progress or cephalopelvic disproportion (4822 [30.3%]), followed by previous uterine scar (2504 [15.7%]), non-reassuring fetal status (2306 [14.5%]), and fetal malpresentation (1746 [11.0%]). Other indications were placenta or vasa previa (794 [5.0%]), uterine rupture (676 [4.3%]), hypertensive disorders (659 [4.1%]), placental abruption (520 [3.3%]), pre-rupture (450 [2.8%]), and cord prolapse (365 [2.3%]).
Indications for cesareans in MSF settings differ from those in higher-income countries. Further investigation is needed for adequate emergency obstetric care coverage.
回顾无国界医生组织（MSF）布鲁塞尔运营中心工作人员实施剖宫产的主要指征。
对2008年至2012年期间所有记录了指征的单胎剖宫产进行回顾性研究。还记录了项目地点、患者年龄、麻醉类型和手术时长。
从17个国家共识别出14151例单胎剖宫产。在记录的15905条指征中，最常见的是产程停滞或头盆不称（4822例[30.3%]），其次是既往子宫瘢痕（2504例[15.7%]）、胎儿状况不良（2306例[14.5%]）和胎位异常（1746例[11.0%]）。其他指征包括前置胎盘或前置血管（794例[5.0%]）、子宫破裂（676例[4.3%]）、高血压疾病（659例[4.1%]）、胎盘早剥（520例[3.3%]）、先兆子宫破裂（450例[2.8%]）和脐带脱垂（365例[2.3%]）。
无国界医生组织环境下剖宫产的指征与高收入国家不同。需要进一步调查以提供充分的紧急产科护理覆盖。
