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目的:探讨经产妇分娩方式、剖宫产率、剖宫产指征的临床变化。方法:对2007年1月至2014年12月间,住院分娩的1 042例经产妇的临床资料进行回顾性分析。结果:1 042例中农村和流动经产妇妊娠期并发症发生率均高于城市孕妇(P<0.01),定期产检的依从性明显低于城市孕妇(P<0.01),流动经产妇阴道分娩率明显高于城市和农村孕妇(P<0.01),不同区域居住地经产妇产后出血发生率比较差异无统计学意义(P>0.05)。与同期初产妇相比,经产妇妊娠期并发症和产后出血发生率较高(P<0.05),两组间剖宫产率比较差异无统计学意义(P>0.05),瘢痕子宫占剖宫产指征的第1顺位,且逐年升高;围产儿预后比较差异无统计学意义(P>0.05)。结论:加强基层医院高危妊娠的孕期管理及产时监护,优化产科服务模式,可有效提高经产妇自然分娩率,严格掌握瘢痕子宫的剖宫产指征,提高围产保健质量。
Objective: To investigate the clinical changes of maternal delivery mode, cesarean section rate and cesarean section indications. Methods: A retrospective analysis was conducted on the clinical data of 1,042 maternal inpatients who were hospitalized between January 2007 and December 2014. Results: The incidence of complications during pregnancy in 1 042 middle-aged and migrant women was higher than that in urban pregnant women (P <0.01), and the compliance of scheduled birth examination was significantly lower than that of urban pregnant women (P <0.01). The vaginal delivery rate (P <0.01). There was no significant difference in the incidence of postpartum hemorrhage between residences in different regions (P> 0.05). Compared with the first trimester maternal complications, the incidence of postpartum hemorrhage and maternal complications were higher (P <0.05). There was no significant difference in cesarean section rate between the two groups (P> 0.05) Indications of the first pick, and increased year by year; perinatal prognosis was no significant difference (P> 0.05). CONCLUSIONS: To strengthen the pregnancy management and antenatal care during the high-risk pregnancy in primary hospitals and optimize the obstetric service mode can effectively increase the rate of natural childbirth and strictly control the indication of cesarean section in scar-shaped uterus and improve the quality of perinatal health care.