Sheehan K H
Lancet. 1987 Mar 7;1(8532):548-51. doi: 10.1016/s0140-6736(87)90185-1.
Retrospective data collected from the medical records of 1040 low-risk nulliparous obstetric patients presenting for delivery in a general community hospital in Ireland and a comparable one in the United States showed a significantly higher rate of caesarean section for dystocia or abnormal labour in the American hospital--a discrepancy which was not easily explained by differences in patient characteristics (eg, maternal age, known risk factors, birthweight). Acceleration of labour with oxytocin was significantly more common in the Irish group, and average duration of labour was shorter. No advantage to the infant, as measured by the Apgar score, resulted from the greater use of caesarean section for dystocia.
从爱尔兰一家普通社区医院以及美国一家类似医院的1040例低风险初产妇分娩病历中收集的回顾性数据显示,美国医院因难产或产程异常进行剖宫产的比例显著更高——这种差异难以用患者特征(如产妇年龄、已知风险因素、出生体重)的不同来解释。爱尔兰组使用缩宫素加速产程的情况明显更为常见,且平均产程更短。就阿氏评分衡量,因难产更多进行剖宫产对婴儿并无益处。