| Objective : A retrospective analysis of hospital caesarean section rate combined with puerpera characteristics,based on Robson classification system.To supervise the information of caesarean section and its surgical indications and puerpera characteristics and infant sex ratio with Two-child policy before and after 3 years simultaneously,as well as its relationship were analyzed.To provide scientific data for monitoring measures of caesarean section rate and clinical practice.Methods: A total of 12041 women who delivered in Hospital were selected from Oct 1,2010 to Sept 30,2016.All maternal medical information were collected through Health Information System in hospital,and through the records about delivery information.The women were divided into ten groups according to the five categories of the pregnancy period and delivery times and delivery mode and position of the fetus and the number of fetal.To analyze trend of hospital total caesarean section rate and its population characteristics and the characteristics of the puerperal.The surgical indications of caesarean were discussed in the primipara and multipara and abnormal presentation maternal and premature birth in the past 4 years(in 2013 to 2016)that the maternal caesarean section declined obviously,as well as its relationship with Two-child policy and infant sex ratio.SPSS 16 software were used to analyze the data.The rate of caesarean section and maternal characteristics were carried out by the trend of the 2 test(theory of frequency less than 1 using Fisher exact test),P < 0.01 was defined as statistically significant.Results:(1)The hospital total caesarean section rate decreased from 66.9% to 44.2% in recent 6 years,the caesarean section rate of monocyesis pregnant full-term primipara group,parous women without uterine scar formation group and early maternal decreased significantly;there was no significant difference in scar uterus,fetal abnormalities in caesarean section rate changes.(2)maternal characteristics distribution in each group showed that constituent ratio of pregnant than single cephalic pregnancy vaginal delivery group(R1,R3),uterine scar pregnancy group(R5),all breech pregnancy groups(R6,R7)and twin pregnancy group(R8)increased,pregnant single cephalic pregnancy caesarean section group(R2,R4)decreased in the past 4 years.(3)The indications for caesarean section ratio showed that monocyesis pregnant full-term primipara group(R2)of umbilical cord factors,fetal distress,oligohydramnios,social factors and cephalopelvic disproportion decreased significantly.Umbilical cord factors,cephalopelvic disproportion and social factors decreased in the group of maternal without uterine scar.Pregnancy complications and the complications of preterm labor group increased significantly;The uterine scar,pregnancy complications are respectively located in the first,second.(4)The hospital total annual birth sex ratio is 110 ~ 128:100,girls population of R1 group was high,group R10(premature)and multipara(R4,R5)male ratio were high,but the R4 group of boys decreased significantly in 2015 and 2016.Conclusion:The differences were significantly in the incidence of caesarean section and the indications of caesarean section among different population characteristics.Single fetal head position primipara,uterus free scar pregnancy and premature are the key monitoring population in hospital to reduce the caesarean section rate.The indications of caesarean section indications such as fetal distress,pelvic disproportion,umbilical cord circling neck and social factors are the key points to strengthen the supervision and administration for medical institutions.There is uncertainty about the change of caesarean section rate and composition ratio in Scar uterus pregnancy,breech presentation and twins pregnancy.The long-term effect of abnormally high caesarean section rates on maternal and child health has been apparent.After the implementation of the "two child" policy,it has a certain impact on the rate of hospital caesarean section.Robson classification system can be used to objectively classify the characteristics of the parturient population,increase the rate of caesarean section,and compare the monitoring data of caesarean section indications. |
