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目的:了解上海市剖宫产现状,为降低剖宫产率提供科学依据。方法:对全市所有助产医疗机构进行全覆盖调研,通过查阅接产登记表、原始病史抽查等多种方法全面了解上海市剖宫产率及其指征等。结果:2010年上半年全市平均剖宫产率为55.4%;非医学指征(社会因素)剖宫产占28.74%;剖宫产医学指征前3位依次为胎窘(57.48%)、头盆不称(24.05%)以及产科并发症(3.96%);节假日急诊手术剖宫产中指征符合率为83.80%,其中“头盆不称”的指征符合率为84.10%,“胎窘”的指征符合率为83.70%;剖宫产手术管理方面存在术前准备不够充分、术后观察记录不够完整、产后出血量估计不足等问题。结论:上海市剖宫产率仍居高不下,非医学指征剖宫产的比例明显上升,提示急需加强健康教育提高孕产妇对剖宫产的科学认知,加强助产专业队伍的培训并积极推广产时适宜技术促进自然分娩,保障母婴安全与健康。
Objective: To understand the status of cesarean section in Shanghai and to provide a scientific basis for reducing the rate of cesarean section. Methods: To investigate the coverage of all midwifery medical institutions in the city and to obtain a comprehensive understanding of cesarean section rate and its indications in Shanghai by referring to a variety of methods such as taking birth registration form and random sampling of the original medical history. Results: The average cesarean section rate in the first half of 2010 was 55.4%; non-medical indications (social factors) accounted for 28.74%; first three indications for cesarean section were fetal distress (57.48%), head (24.05%) and obstetric complications (3.96%). The coincidence rate of cesarean section in holiday emergency operation was 83.80%, of which 84.10% Fetal embolism, "the coincidence rate of 83.70% indications; surgical management of cesarean section there is insufficient preoperative preparation, postoperative observation is not complete record, lack of postpartum hemorrhage estimates and other issues. Conclusion: The rate of cesarean section in Shanghai is still high. The proportion of cesarean section in non-medical indications is obviously increased, which indicates that there is an urgent need to strengthen health education to improve maternal awareness of cesarean section and strengthen the training of midwifery professionals. Promote timely delivery of suitable technologies to promote natural childbirth and ensure the safety and health of mothers and children.