Sehgal N N
J Community Health. 1981 Fall;7(1):33-46. doi: 10.1007/BF01323079.
The indications for all cesarean sections done at Charleston Area Medical Center from 1972 to 1979 were reviewed. The cesarean section rate rose from 4.4% in 1972 to 8.8% in 1975, to 17.2% in 1979. Repeat cesarean sections accounted for 30.3% of all cesarean sections. The increase in the rate of primary cesarean sections was due to more cesarean sections being done for old indications as well as for the additional indications. From 1972 to 1979, cesarean sections performed for indication of dystocia increased threefold, for fetal distress ninefold, and for breech presentation elevenfold. Dystocia, however, remained the leading indication for primary cesarean section. Even though more cesarean sections and fetal surveillance tests were done from 1976 to 1979 than from 1972 to 1975, the perinatal mortality rate during the two four-year periods was not significantly different. Recommendations are made to a more objective and rational evaluation of the need to perform cesarean sections and for a periodic audit of both the operation and cost-effectiveness of the newer technology.
回顾了1972年至1979年在查尔斯顿地区医疗中心进行的所有剖宫产手术的指征。剖宫产率从1972年的4.4%上升到1975年的8.8%，再到1979年的17.2%。再次剖宫产占所有剖宫产的30.3%。首次剖宫产率的上升是由于因原有指征以及新增指征而进行的剖宫产手术增多。从1972年到1979年，因难产指征进行的剖宫产手术增加了两倍，因胎儿窘迫增加了九倍，因臀位增加了十一倍。然而，难产仍然是首次剖宫产的主要指征。尽管1976年至1979年比1972年至1975年进行了更多的剖宫产手术和胎儿监测检查，但这两个四年期间的围产期死亡率并无显著差异。建议对剖宫产手术的必要性进行更客观、合理的评估，并对新技术的手术操作和成本效益进行定期审核。
