ABSTRACT
In 1930s, Wolf created the first partogram. In 1950s, Friedman proposed the classical model of partogram that has been applied in clinical labor assessment ever since. Over the past ten years, Zhang has made great improvement in this field. Here, we reviewed the three different stages in partogram research (the first proposed stage, Friedman's classical stage and Zhang's stage) in terms of its background, demographic characteristics and clinical application. Moreover, this article also emphasized the necessity of partogram research and discussed the prospects for future research and clinical application based on the recent progress in China.
ABSTRACT
Objective To investigate the changes of cesarean section rate and indications in different level hospitals of different areas in China during 2000 to 2009. Methods Literatures published in Chinese journals on variation of cesarean section rate and indications from 2000 to 2009 were analyzed. Cochran-Armitage test was used to analyze the trend. The differences of cesarean section rate between different areas or different level hospitals were analyzed by chi-square test.Results Forty-nine papers were enrolled in this study.Cesarean section rate had risen from 2000 (32.1％,10 353/32 258) to 2009 (52.5％,3674/6992)(Z=-20.8267,P＜0.01).During 2000 to 2008,the average cesarean section rate of level one grade A hospital was 45.7％ (3754/8214),which was higher than 34.5％(25 015/72 507) in level three grade A hospital and 32.3％(28 140/87 121) in level two grade B hospital (P＜0.05,respectively).Except for level three grade A hospital,cesarean section rate had risen in the other two level hospitals during 2003 to 2008. The average cesarean section rate was 58.6％ (4982/8502) in northeast area during 2000 to 2007,which was higher than that of other areas (P＜0.01); and the average cesarean section rate was 27.5％ (12 264/44 595) in central China and 33.0％ (23 239/70 421) in southern China,which were lower than that of other areas (P＜ 0.01 ). Social factor,instead of dystocia,became the most important indication for cesarean section,and its proportion kept rising annually,from 11.3％ (1170/10 353) in 2000 to 27.1％(2094/7726) in 2008 and remained above 20.0％(5159/24 691) since 2004.The proportion of scar uterus rose from 6.7％(694/10 353) in 2000 to 12.5％ (459/3674) in 2009. Conclusions Cesarean section rate rises fast and its major indications had changed in China. It is suggested that special method should be taken to control the current situation.