Haydar Ahmad, Vial Yvan, Baud David, Desseauve David
Département femme-mère-enfant, CHUV, 1011 Lausanne.
Rev Med Suisse. 2017 Oct 25;13(580):1846-1851.
We conducted a retrospective study was conducted in the Centre Hospitalier Universitaire Vaudois (CHUV) including all births between the 1st January 1997 and 31st December 2011 to analyze the cesarean section (CS) rate using the different groups of the Robson classification in a Swiss maternity hospital. The overall CS rate was 29 %, mainly related to group 5 (multiparous with previous CS) and group 2 (nulliparous women induced or who had CS before labor). The study also shows that induction of labor on maternal request in nulliparous at term (group 2a) increased significantly the risk of CS compared to induction of labor for medical reason (p<0.001). The Robson classification system appears as a simple tool for monitoring CS rates. The main strategies for reducing CS rates will be through better selection of women for VBAC (vaginal birth after caesarean) and limitation of induction of labor, especially in nulliparous women.
我们在沃州大学中心医院（CHUV）进行了一项回顾性研究，该研究涵盖了1997年1月1日至2011年12月31日期间的所有分娩情况，以分析瑞士一家妇产医院使用罗布森分类不同组别的剖宫产（CS）率。总体剖宫产率为29%，主要与第5组（有既往剖宫产史的经产妇）和第2组（引产或临产前进行剖宫产的初产妇）有关。该研究还表明，与因医学原因引产相比，足月初产妇因产妇要求引产（第2a组）显著增加了剖宫产风险（p<0.001）。罗布森分类系统似乎是监测剖宫产率的一个简单工具。降低剖宫产率的主要策略将是更好地选择进行剖宫产后阴道分娩（VBAC）的女性，并限制引产，尤其是初产妇。
