Scholtes G
Z Geburtshilfe Perinatol. 1975 Jun;179(3):215-23.
On the basis of a large schema of indications (tab. 1, 2) 1241 Caesarean sections during 1966-1973 are analysed. The following points can be summarized: 1) The percentage rose from 6.4% (1966) to 10.75% (1973) (Fig. 1). 2) The percentage of Caesarean sections decided on for the sake of the child rose from 54% (1966/67) to 63.9 (1972/73) (tab. 3). 3) Vital indications fell due to increasingly preventive obstetrics from 71.7% (1966) to between 30% and 41.3% (1973) (tab. 4). 4) Perinatal mortality of 1258 children delivered by Caesarean section was 4.05% (tab. 5). Of Children delivered surgically for vital indications 6.1% died, of those delivered surgically for preventive indications only 0.9% died in the perinatal period (tab. 6). 5) This shift from the vital towards preventive indication is particularly pronounced for repeated Caesarean section (tab. 7) and for breech presentation (tab. 8). 6) Maternal mortality after Caesarean section reached 3.2%, after spontaneous delivery only 0.16%. This great difference in the maternal risk between those treated with Caesarean section and those with spontaneous delivery emphasizes the need for indications for Caesarean section which are critical, conscious of the responsibility and not too generous.
基于一个大型适应症模式（表1、2），对1966 - 1973年间的1241例剖宫产进行了分析。可总结出以下几点：1）该百分比从1966年的6.4%升至1973年的10.75%（图1）。2）因胎儿原因决定进行剖宫产的百分比从1966/67年的54%升至1972/73年的63.9%（表3）。3）由于预防性产科的日益普及，紧急适应症从1966年的71.7%降至1973年的30%至41.3%之间（表4）。4）1258例剖宫产分娩儿童的围产期死亡率为4.05%（表5）。因紧急适应症接受手术分娩的儿童中有6.1%死亡，因预防性适应症接受手术分娩的儿童在围产期仅0.9%死亡（表6）。5）这种从紧急适应症向预防性适应症的转变在再次剖宫产（表7）和臀位分娩（表8）中尤为明显。6）剖宫产后的产妇死亡率达到3.2%，自然分娩后仅为0.16%。剖宫产与自然分娩产妇风险的巨大差异强调了剖宫产适应症必须严格、慎重且不随意。
