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目的:对上海市浦东新区高桥镇产妇剖宫产现况进行调查,分析其影响因素,探讨降低剖宫产率及加强孕期保健的方法。方法:随机抽取2010年7月至2011年6月期间上海市浦东新区高桥镇799例产妇为研究对象,利用相关医务人员在产妇出院后的两次上门家访时,采用自行设计的社会人口学调查表进行问卷调查。调查内容包括患者的一般资料以及剖宫产手术指征,分析产妇剖宫产的影响因素。结果:①剖宫产主要手术指征包括社会因素(32.22%)、妊娠合并症(27.93%)、胎位异常(8.38%)、难产(7.64%)、羊水异常(7.26%)、瘢痕子宫(6.70%)、胎儿窘迫(5.21%)、其他(4.66%)。②剖宫产与孕妇基本情况(户籍、医疗保险)密切相关。结论:剖宫产因素构成复杂,其中社会因素影响最大;孕妇的户籍及医疗保险情况也会影响其生产方式。因此可通过产前健康教育,改变产时服务模式,完善助产技术,避免经济利益干扰等措施降低社会因素对剖宫产率的影响。
Objective: To investigate the status of cesarean section in Gaoqiao Town, Pudong New Area in Shanghai, analyze its influencing factors, and explore ways to reduce the rate of cesarean section and strengthen the health care during pregnancy. Methods: From July 2010 to June 2011, 799 maternal women from Gaoqiao Town, Pudong New Area, Shanghai were randomly selected as the study subjects. By using relevant medical staffs, two self-designed social demography Questionnaire survey. The survey included general information about patients and cesarean section indications, analysis of factors affecting cesarean section. The main indications for cesarean section included social factors (32.22%), pregnancy complications (27.93%), fetal position abnormalities (8.38%), dystocia (7.64%), amniotic fluid abnormalities (7.26% %), Fetal distress (5.21%), others (4.66%). ② cesarean section and the basic situation of pregnant women (household registration, medical insurance) are closely related. Conclusion: The causal factors of cesarean section are complicated, among which the social factors have the greatest impact. The maternity domicile and the medical insurance will also affect the mode of production. Therefore, we can reduce the impact of social factors on cesarean section rate through prenatal health education, changing the service mode of birth, perfecting midwifery techniques and avoiding interference with economic interests.