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目的探讨剖宫产率上升与剖宫产指征、阴道手术助产和母儿病率之间的关系。方法对比分析1986、1997年我院产科1937例病人的剖宫产率、剖宜产指征、阴道手术助产率及母儿病率。结果1986年剖宫率16．2％，胎儿窘迫列剖宫产指征第2位（19．1％）；1997年剖宫产率29．1％，胎儿窘迫列指征第1位（42．7％），其回顾性诊断的正确率由57．1％降至15．6％。阴道手术助产率由23．1％降至12．5％。臀位剖宫产率由15．0％上升至85．0％；新生儿病率由23．7％降至9．3％；产后出血率则由6．3％上升至17．0％（P值均＜0．005）。结论剖宫产指征的变化和阴道手术助产率的下降是剖宫产率升高的主要原因。一定范围的剖宫产率上升降低了新生儿病率，增加了产后出血率。要防止剖宫产率的继续上升及对母儿可能造成的危害，需要从严格掌握剖宫产指征，提高产科医生的素质着手。
Objective To investigate the relationship between cesarean section rate and indication of cesarean section, midwifery and maternal morbidity. Methods Comparisons of cesarean section rates, indications of appropriate induction of labor, vaginal surgery midwifery rates and maternal and child morbidity in 1937 patients in our hospital from 1986 to 1997 were analyzed. Results The rate of cesarean section was 16.2% in 1986, and the second was fetal distress cesarean section (19.1%). The incidence of cesarean section in 1997 was 29.1%, and the index of fetal distress was 42 .7%). The correct rate of retrospective diagnosis decreased from 57.1% to 15.6%. Vaginal surgery midwifery rate decreased from 23.1% to 12.5%. Cesarean section rate increased from 15.0% to 85.0% in the buttocks; the neonatal morbidity dropped from 23.7% to 9.3%; the rate of postpartum hemorrhage increased from 6.3% to 17.0% ( P <0.005). Conclusion The changes of indications of cesarean section and the reduction of vaginal delivery rate are the main reasons for the increase of cesarean section rate. A range of increases in cesarean delivery reduces neonatal morbidity and increases the rate of postpartum hemorrhage. To prevent the continued rise in cesarean section rate and the possible harm to the mother and child, we need to strictly grasp the indications of cesarean section and improve the quality of obstetricians.