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目的:分析经产妇分娩方式及难产因素,探讨经产妇各项剖宫产指征的合理性,寻求降低经产妇剖宫产率的对策,提高经产妇母儿安全水平。方法:将1999年3月～2009年2月无妊娠合并症的537例经产妇按分娩时间分为前5年组和后5年组,对其基本特征、分娩方式、难产主要因素进行分析比较。结果:后5年组与前5年组比较,经产妇年龄呈明显增加趋势;自然分娩率、阴道助产率、臀位助产率降低,剖宫产率增高;臀位妊娠发生率无变化,瘢痕子宫比例明显增加,其剖宫产率均明显增高。结论:应加强经产妇的围产期保健及高危妊娠管理,重视有阴道助产史和胎儿体重较前次分娩新生儿体重有较大增加的孕妇的产程,避免发生母儿并发症;通过降低臀位妊娠和瘢痕子宫经产妇的剖宫产率,可以合理降低经产妇的剖宫产率。
OBJECTIVE: To analyze the mode of delivery through childbirth and the factors of dystocia, to explore the rationality of indications of cesarean section by maternity, to find ways to reduce cesarean section rate and to improve the safety level of maternal and mum. Methods: 537 pregnant women without pregnancy complications from March 1999 to February 2009 were divided into the first 5 years and the later 5 years according to the time of delivery, and their basic characteristics, modes of delivery and the main factors of dystocia were analyzed and compared . Results: Compared with the first five years, the maternal age increased obviously. The rates of spontaneous delivery, vaginal delivery and breech delivery decreased while the rate of cesarean section increased. The incidence of breech pregnancy did not change , The proportion of scar uterus increased significantly, the cesarean section rate was significantly higher. Conclusions: Maternal perinatal care and high-risk pregnancy management should be strengthened, and the birth course of pregnant women who have a history of vaginal delivery and heavier weight than that of the previous delivery should be emphasized to avoid maternal and child complications. By reducing Cesarean pregnancy and scar cesarean section through the rate of cesarean section, can be reasonably reduced by maternal cesarean section rate.