Investigation and analysis of cesarean section rate and indications in Shanghai / 中国实用妇科与产科杂志

ABSTRACT

OBJECTIVE:To study the current status of cesarean section rate(CSR)and cesarean section(CS)indications in Shanghai,and to provide basic evidence for reducing the rate of CS.METHODS:Six general and maternal and child hospi⁃tals(MCH)in Shanghai were selected,and all data of childbirth of these hospitals in 2016 were collected.The total CSR was calculated for all hospitals and the Chi-square tests were used to compare the CSR among different hospitals.The constitution of CS indications were reported by using the data collected from two out of the six hospitals.RESULTS:The to⁃tal CSR of all hospitals in this study was 47.88%(95% CI 47.30%-48.46%).The CSR in suburb an hospitals was signifi⁃cantly higher than that in outer suburbs and city center(51.72% vs. 50.54% vs. 43.24%,P<0.01),The CSR in secondary hospitals was significantly higher than that in tertiary hospitals(49.73% vs. 46.36%,P<0.01).The CSR in general hospi⁃tals was higher than that in MCH(54.54% vs. 43.81%,P<0.01).The CS without medical indications or for social reasons accounted for 25.15% of all CS,while the scar uterus(36.31%),maternal pregnancy-related complications(13.17%)and abnormal fetal head position(6.33%)were the three leading medical indications of CS.CONCLUSION:The CSR in Shang⁃hai is at a high level.There are significant differences in CSR among different hospitals.The scar uterine and social rea⁃sons are the leading causes of CS in Shanghai.