Analysis On The Cesarean Section Rate And The Indication In Four Years

Objective:To analyze the changes of the rate and indication of cesarean section, and explore the measures to reduce the cesarean section.Methods:This is a retrospective study based on 11052 cases of maternal who labor in hospital from January 2012 to December 2015 in the first Affiliated Hospital of Fujian Medical University, with 6169 cases cesarean delivery.Compare the trends of cesarean rate and indication annually, and the changes of cesarean indication before and after the new labor limit standard.Also analyze the first cesarean indication of previous uterine surgery, to discuss the main factors influencing the changes of cesarean section indications. Statistical analysis was performed with Chi-square test and Fisher’s exact probability test of SPSS19.0 package.Results: 1.In the 11052 cases of maternal, 6169 casesarecesarean delivery(55.82%,6169/11052),4702 are vaginal delivery(42.54%,4702/11052),and 181 areoperative vaginal delivery(1.64%,181/11052).From 2012 to 2015,the cesarean rate of our hospital is 61.16%、60.68%、52.09%、49.39% respectively, showing a decrease trend year by year, compared 61.16% in 2012 to 49.39% in 2015,has a highly statistically significant difference(P<0.05),and there is upward in vaginal delivery, with highly statistically significant(P<0.05) 2.The changes of cesarean indication from 2012 to 2015 in our hospital is the social factors and the scar uterus,which still stand the top two. And there is an upward trend in scar uterus, while, the social factors is on the decline, with highly statistically significant(P<0.05);Labor time abnormal decline year by year,while a rising trend in the pregnancy complication,comparing differences between each year have statistical significance(P<0.05).The cesarean indication rate of macrosomia, oligohydramnios and amniotic fluid contamination have statistical significance between each year(P<0.05),other indication has no statistical significance(P>0.05). 3.The permutation order of the cesarean indications each year: social factor is in the first place by 2012-2013, drop to the second place in 2014-2015. Scar uterus is just the opposite. Labor time abnormal line down, pregnancy complications rise, while fetal distress doesn’t change significantly. 4.After the introduction of the new labor limit standard, the rate of labor abnormal decreased significant, with difference statistically significant(P<0.05).Scar uterus and macrosomia after new labor rise, and social factors down, with highly statistically significant(P<0.05).Other indications have not statistical significance(P>0.05). 5.The first time cesarean indication of 644 cases scar uterus is mainly in social factors、fetal presentation abnormal and macrosomia,the rate is 27.0%,12.7%,12.1% respectively.Conclusion: 1.The cesarean rate of our hospital shows a decrease trend year by year from 2012 to 2015, but still in high level. 2.With the decrease of the social factors, the main causes influent the cesarean rate is the increasing number of scar uterus. Strictly grasp the first cesarean section indication, and reduce the no medical indications cesarean. 3.Promote the implementation of the new labor limit standard, and make it standardize, proceed adequate trial production, to increase the vaginal births. 4.Tostrengthen the interpretation of fetal monitor graphic, judge the fetal distress comprehensively, pay attention to the management of complications during pregnancy, and correct the abnormal position actively, to reduce the rate of cesarean delivery.