Abstract：Objective To compare the differences in characteristics of women with cesarean delivery and cesarean indications between secondary and tertiary hospitals. Methods From August 2013 to July 2014, a survey was conducted among pregnant women who underwent cesarean section in two secondary hospitals in Hebei province and one tertiary hospital in Inner Mongolia. To collect information on maternal characteristics and indications for cesarean section, questionnaires were administered by trained obstetricians or nurses before women were discharged from hospitals. T tests and Chi-square tests were performed to compare the differences in maternal characteristics and indications for cesarean section between hospitals. Results 1 608 women were surveyed, and 1 400 remained in the analysis, including 1 146 from the secondary hospitals and 254 from the tertiary hospital. A majority of women who delivered in the secondary hospitals were farmers, while almost all women who delivered in the tertiary hospital were non-farmers. Both the proportions of nulliparous women and women aged≥35 years in the secondary hospitals (37.4%, 2.8%) were significantly lower than those in the tertiary hospital (79.1%, 9.1%) (P<0.001). There were similarities regarding cesarean indications between hospitals. Subjective indications for nulliparous women in both secondary and tertiary hospitals, including fetal distress, relative cephalopelvic disproportion/cord entanglement, and non-medical factors, accounted for >40%; moreover, for multiparous women, repeated cesarean accounted for >60%. There were also dissimilarities. Both the proportions of women undergoing a repeated cesarean and those undergoing a cesarean for a single indication were significantly higher in the secondary hospitals than those in the tertiary hospital. Conclusion Before the selective two-child policy took effect, the proportion of women aged ≥35 years had been <10% among those undergoing a cesarean delivery, even in tertiary hospital. More than two fifths of nulliparous pregnant women in both hospitals underwent cesarean with more subjective indications, suggesting a need to control medically unnecessary cesarean sections. Four fifths of multiparous pregnant women undergoing cesarean delivery in the secondary hospitals were of repeated cesarean delivery, suggesting a need to advocate vaginal delivery and to improve service capacity in low level hospitals.
廖紫珺, 周玉博, 周燕, 李宏田, 司可艺, 刘建蒙. 不同级别医院剖宫产产妇特征与指征构成分析[J]. 中国生育健康杂志, 2018, 29(2): 106-109.
LIAO Zijun, ZHOU Yubo, ZHOU Yan, LI Hongtian, SI Keyi, LIU Jianmeng. Characteristics of women undergoing cesarean delivery and indications for cesarean section:A comparative study between hospitals of different levels. Chinese Journal of Reproductive Health, 2018, 29(2): 106-109.
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