Roberge Stéphanie, Dubé Eric, Blouin Simon, Chaillet Nils
Department of Obstetrics, Gynecology, and Reproduction, Université Laval, Quebec City, QC.
Department of Obstetrics, Gynecology, and Reproduction, Université Laval, Quebec City, QC.
J Obstet Gynaecol Can. 2017 Mar;39(3):152-156. doi: 10.1016/j.jogc.2016.10.010.
The increasing rates of Caesarean sections throughout the world is preoccupant, and a good understanding of which groups of women contribute the most to the CS rate represents an important question in public health. Therefore, we sought to report the CS rate according to the Robson's classification system in the Quebec population.
We performed a secondary analysis of the QUARISMA database, including all deliveries after 24 weeks' gestation from 32 maternity wards in the province of Quebec between 2008 and 2011 (n = 184 952 deliveries). CS rates were reported according to the modified Robson criteria from The Society of Obstetricians and Gynaecologists of Canada with the relative contribution to the total number of CSs.
We observed a global CS rate of 22.9%. Women with previous CS and a fetus in cephalic presentation at term accounted for 35% of all Caesarean deliveries. Nulliparous women with cephalic presentation at term accounted for 30% of all CSs. Among nulliparous women with cephalic presentation, women with spontaneous labour contributed to 12% of all CSs, whereas women with an induction of labour contributed to 16% of all CSs. Non-cephalic fetal presentation accounted for 19% of all CSs. Other indications accounted for the remaining 16% of CSs.
Most CSs are performed for multiparous women with previous CS; nulliparous women with a cephalic presentation at term, especially those undergoing labour induction; and non-cephalic fetal presentation.
全球剖宫产率不断上升令人担忧，深入了解哪些女性群体对剖宫产率的影响最大是公共卫生领域的一个重要问题。因此，我们试图根据罗布森分类系统报告魁北克人群的剖宫产率。
我们对QUARISMA数据库进行了二次分析，纳入了2008年至2011年期间魁北克省32个产科病房妊娠24周后的所有分娩（n = 184952例分娩）。根据加拿大妇产科学会修改后的罗布森标准报告剖宫产率及其对剖宫产总数的相对贡献。
我们观察到总体剖宫产率为22.9%。有剖宫产史且足月时胎儿为头先露的女性占所有剖宫产分娩的35%。足月时头先露的初产妇占所有剖宫产的30%。在足月头先露的初产妇中，自然分娩的女性占所有剖宫产的12%，而引产的女性占所有剖宫产的16%。非头先露胎儿占所有剖宫产的19%。其他指征占剖宫产的其余16%。
大多数剖宫产是针对有剖宫产史的经产妇；足月时头先露的初产妇，尤其是引产的初产妇；以及非头先露胎儿进行的。
