Metwali Nada Y, Ahmed Ruqayyah A, Hussain Timraz Jumana, Irfan Husna, Makarfi Samira M, Metwali Mohammed Y, Orfali Mohammad T, Fadl Jina K
Department of General Medicine and Surgery, Batterjee Medical College for Science and Technology, Jeddah, SAU.
Master of Public Health Program, Gulf Medical University, Dubai, ARE.
Cureus. 2024 Nov 29;16(11):e74729. doi: 10.7759/cureus.74729. eCollection 2024 Nov.
The increase in cesarean section (CS) rates, whether they are classified as unnecessary or elective, has globally raised significant concerns due to the associated risks involving maternal and neonatal outcomes. Although CS can be a lifesaving operation in specific medical cases, its overuse is exposing mothers and neonates to complications like hemorrhage, infections, and long-term consequences such as uterine scarring, infertility, and future pregnancy problems. The contributing factors include maternal preferences for convenience, fear of labor, and financial incentives within the healthcare systems that favor surgical interventions. Defensive medical practices and private healthcare providers further exacerbate this trend. This review discusses the prevalence of CS, highlighting variations between developing and developed regions and the complexity of addressing the rising rates. Moreover, recommendations to reduce unnecessary CS, such as enhancing antenatal education to inform mothers about the risks and benefits associated with different delivery options, promoting supportive care models (midwives), and fostering interdisciplinary cooperation among healthcare providers, will also be addressed. Healthcare systems will gain the ability to reduce the rates of unnecessary Cesarean procedures by directing the main focus on patient education, continuous monitoring, and policy reforms. This will lead to the improvement of both neonatal and maternal health outcomes in addition to lowering the costs of healthcare. In order to provide and ensure evidence-based and safe care for childbirth, a multidisciplinary approach is essential.
剖宫产率的上升，无论被归类为不必要的还是选择性的，由于涉及孕产妇和新生儿结局的相关风险，在全球范围内引发了重大关注。虽然剖宫产在特定医疗情况下可能是一种挽救生命的手术，但其过度使用正使母亲和新生儿面临出血、感染等并发症，以及子宫瘢痕形成、不孕和未来妊娠问题等长期后果。促成因素包括母亲对便利性的偏好、对分娩的恐惧，以及医疗保健系统中有利于手术干预的经济激励措施。防御性医疗行为和私立医疗服务提供者进一步加剧了这一趋势。本综述讨论了剖宫产的流行情况，强调了发展中地区和发达地区之间的差异以及应对不断上升的剖宫产率的复杂性。此外，还将讨论减少不必要剖宫产的建议，例如加强产前教育，让母亲了解不同分娩方式的风险和益处，推广支持性护理模式（助产士），以及促进医疗服务提供者之间的跨学科合作。医疗保健系统将能够通过将主要重点放在患者教育、持续监测和政策改革上，来降低不必要的剖宫产手术率。这除了降低医疗保健成本外，还将改善新生儿和孕产妇的健康结局。为了提供并确保基于证据的安全分娩护理，多学科方法至关重要。
