Brick A, Layte R, Farren M, Mahony R, Turner M J
Economic and Social Research Institute, Whitaker Square, Sir John Rogerson's Quay, Dublin 2.
Trinity College Dublin, Dublin 2.
Ir Med J. 2016 Dec 12;109(10):482.
In developed countries, caesarean section (CS) rates continue to escalate and in Ireland nearly one in three women are now delivered by CS. The purpose of this study was to compare the management of women after one previous CS in two large Dublin maternity hospitals with the management in two other well-resourced countries. Data were analysed for Dublin, Massachusetts in the United States, and Hesse in Germany. It was found that since 1990, the CS rate in Dublin has increased by much more than in the other areas. This increase may be explained by the precipitous fall in the vaginal birth after CS rate because the rates in Massachusetts and Hesse in 1990 were initially much lower. Changes in the clinical management of women with one previous CS are a major contributor to the rising CS rates and are likely to be an ongoing driver of CS rates unless clinical practices evolve.
在发达国家，剖宫产率持续攀升，在爱尔兰，如今近三分之一的女性通过剖宫产分娩。本研究的目的是比较都柏林两家大型妇产医院中曾有过一次剖宫产史的女性的管理情况与另外两个资源充足国家的管理情况。对美国马萨诸塞州的都柏林、以及德国黑森州的数据进行了分析。研究发现，自1990年以来，都柏林的剖宫产率增长幅度远高于其他地区。这种增长可能是由于剖宫产术后阴道分娩率急剧下降所致，因为1990年马萨诸塞州和黑森州的该比率最初要低得多。曾有过一次剖宫产史的女性临床管理的变化是剖宫产率上升的主要原因，而且除非临床实践有所改进，否则很可能会持续推动剖宫产率上升。
