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一家农村教学医院7年间使用罗布森分类法对剖宫产情况的分析与趋势

Analysis and trends of caesarean sections using Robson's classification over 7-year period at a rural teaching hospital.

作者信息

Nadella Mahathi, Maila Shyam S, Nagelli Indira, Basany Kalpana

机构信息

Department of Obstetrics and Gynecology, Society for Health Allied Research and Education, MediCiti Institute of Medical Sciences, Hyderabad, Telangana, India.

出版信息

J Family Med Prim Care. 2024 Dec;13(12):5550-5554. doi: 10.4103/jfmpc.jfmpc_516_24. Epub 2024 Dec 9.

Abstract

BACKGROUND

A ten-group classification system of caesarean section was proposed by Michael Robson in 2001. It is helpful in comparing the rates of caesarean section between hospitals. The objective of this study was to determine the caesarean section rates to analyse trends of caesarean section and classify according to Robson's categories.

METHODS

This cross-sectional study was conducted from 2016 to 2022. A total of 3176 women who underwent caesarean section were grouped under Robson's ten-group classification system.

RESULTS

The most common group was Group 5 (All multiparous women with at least one previous uterine scar, with single cephalic pregnancy, ≥37 weeks gestation) followed by Group 2 (Nulliparous women, with single cephalic pregnancy, >37 weeks gestation who either had labour induced or were delivered by caesarean section before labour). Results were obtained for the specified period (from 2016 to 2022), and Group 5 contributes more to the total CS rates (45% in 2016, 46% in 2017, 46% in 2018, 57% in 2019, 49% in 2020, 52% in 2021, 54% in 2022), followed by Group 2 (20% in 2016, 17% in 2017, 18% in 2018, 19% in 2019, 26% in 2020, 24% in 2021, 24% in 2022).

CONCLUSION

Pregnant women with prior uterine scars contribute more to caesarean section rates according to Robson's categories. Hence, strategies must be implemented to lower the primary caesarean section rates.

摘要

背景

2001年迈克尔·罗布森提出了剖宫产的十组分类系统。它有助于比较不同医院的剖宫产率。本研究的目的是确定剖宫产率,分析剖宫产趋势,并根据罗布森分类进行分类。

方法

本横断面研究于2016年至2022年进行。共有3176例行剖宫产的妇女按照罗布森十组分类系统进行分组。

结果

最常见的组是第5组(所有有至少一次子宫瘢痕的经产妇,单头位妊娠,妊娠≥37周),其次是第2组(未产妇,单头位妊娠,妊娠>37周,引产或临产前剖宫产)。得出了特定时期(2016年至2022年)的结果,第5组对总剖宫产率的贡献更大(2016年为45%,2017年为46%,2018年为46%,2019年为57%,2020年为49%,2021年为52%,2022年为54%),其次是第2组(2016年为20%,2017年为17%,2018年为18%,2019年为19%,2020年为26%,2021年为24%,2022年为24%)。

结论

根据罗布森分类,有子宫瘢痕的孕妇对剖宫产率的贡献更大。因此,必须实施策略以降低首次剖宫产率。

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Towards safer childbirth: a journey of a thousand miles.迈向更安全的分娩:千里之行。
Acta Obstet Gynecol Scand. 2022 Jul;101(7):837-838. doi: 10.1111/aogs.14381. Epub 2022 May 15.
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Methods of achieving and maintaining an appropriate caesarean section rate.实现和维持适当剖宫产率的方法。
Best Pract Res Clin Obstet Gynaecol. 2013 Apr;27(2):297-308. doi: 10.1016/j.bpobgyn.2012.09.004. Epub 2012 Nov 3.
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Evidence-based surgery for cesarean delivery.剖宫产的循证医学手术
Am J Obstet Gynecol. 2005 Nov;193(5):1607-17. doi: 10.1016/j.ajog.2005.03.063.

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