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目的:了解剖宫产分娩情况,为采取干预措施降低剖宫产率提供依据。方法:收集2009年全市各助产医疗机构的分娩登记本资料并进行分析。结果:①上海市剖宫产率为52.7%,其中该市户籍者剖宫产率为68.7%,外地户籍者剖宫产率为44.3%。②全年剖宫产数分布有明显的高峰,高峰日大都是吉利日、长假前、下半年开学前。③剖宫产的指征中社会因素为首位(占34.9%),尤其在剖宫产高峰日的社会因素指征高达41.7%。该市户籍者中社会因素剖宫产比例(48.4%)显著高于外地户籍者(23.8%)。胎儿窘迫和妊娠合并症分别为剖宫产的第二、三位指征(比例分别为18.2%、10.3%)。④剖宫产的产后出血量(240 ml)显著高于阴道产的产后出血量(194.8 ml)。结论:上海市的剖宫产分布呈现与阴道分娩明显不同的高峰现象,而社会因素又是剖宫产的主要原因,提示加强健康教育提高社会尤其是孕妇及其家属对分娩方式利弊的认知水平极为重要和迫切。
Objective: To understand the cesarean section delivery situation, to provide the basis for interventions to reduce cesarean section rate. Methods: The data of birth attendance of all midwifery medical institutions in 2009 were collected and analyzed. Results: ① The rate of cesarean section in Shanghai was 52.7%, of which cesarean section rate was 68.7% in the city dwellers and cesarean section rate was 44.3%. ② cesarean section throughout the year the number of distribution of significant peaks, mostly auspicious day peak, before the holiday, before the second half of the school. ③ Social indicators of cesarean section in the first place (34.9%), especially in cesarean section on the peak day of social indicators as high as 41.7%. Cesarean section rate of social factors (48.4%) was significantly higher in urban residents than that in rural areas (23.8%). Fetal distress and pregnancy complications were the second and third indications for cesarean section (18.2% and 10.3%, respectively). Postpartum bleeding in cesarean section (240 ml) was significantly higher than that in vaginal delivery (194.8 ml). Conclusion: The distribution of cesarean section in Shanghai shows obviously different peak from that of vaginal delivery, and the social factor is the main reason of cesarean section. It suggests that strengthening health education can increase the awareness of the society about the advantages and disadvantages of delivery methods especially for pregnant women and their families. The level is extremely important and urgent.