CESAREAN BIRTH - HOW TO REDUCE THE RATE

被引：64

作者：

PAUL, RH

MILLER, DA

机构：

[1] Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women's and Children's Hospital, Los Angeles County-University of Southern California Medical Center, Los Angeles, California

来源：

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 1995年 / 172卷 / 06期

关键词：

CESAREAN SECTION; DYSTOCIA; VAGINAL BIRTH AFTER A PRIOR CESAREAN SECTION; UTERINE SCAR;

D O I：

10.1016/0002-9378(95)91430-7

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

The cesarean section rate, which approached 25%, has stabilized and started a modest decline. A stated United States national goal by the year 2000 is a rate of 15%. Suggested rates are 12% for primary and 3% for repeat cesarean sections. The major indications for cesarean section are prior cesarean delivery (8%), dystocia (7%), breech presentation (4%), fetal distress (2% to 3%), and others. The major areas of reduction must occur in the categories of prior cesarean delivery and dystocia. An expanded use of trial of labor and vaginal birth after a prior cesarean section will produce further reductions. Countries in Europe achieve >50% vaginal birth after a prior cesarean section compared with 25% in the United States. A heightened awareness must occur regarding the decision to perform the first cesarean section. The residual impact, a scarred uterus, affects 12% to 14% of women seen for delivery. Even if 50% achieve a vaginal birth after a prior cesarean section, the national goals are unachievable. The obstetrician must consciously consider the impact of ''once a cesarean, always a scar.''

引用

页码：1903 / 1911

页数：9

共 50 条

[21]

Notzon FC, International differences in the use of obstetric interventions, JAMA, 263, pp. 3286-3291, (1990)

[22]

Macara LM, Murphy KW, The contribution of dystocia to the cesarean section rate, Am J Obstet Gynecol, 171, pp. 71-77, (1994)

[23]

O'Driscoll K, Foley M, MacDonald D, Active management of labor as an alternative to cesarean section for dystocia, Obstet Gynecol, 63, pp. 485-490, (1984)

[24]

Lopez-Zeno JA, Peaceman AM, Adashek JA, Socol ML, A controlled trial of a program for the active management of labor, New England Journal of Medicine, 326, pp. 450-454, (1992)

[25]

Craigin E, Conservation in obstetrics, N Y State J Med, 104, pp. 1-3, (1916)

[26]

Miller DA, Diaz F, Paul RH, Vaginal birth after cesarean: a 10-year experience, Obstet Gynecol, 84, pp. 255-258, (1994)

[27]

Flamm BL, Goings JR, Liu Y, Wolde-Tsadix G, Elective repeat cesarean delivery versus a trial of labor: a prospective multicenter study, Obstet Gynecol, 83, pp. 927-932, (1994)

[28]

Kirk EP, Doyle KA, Leigh J, Garrard ML, Vaginal birth after cesarean births or repeat cesarean: medical risks or social realities, Am J Obstet Gynecol, 162, pp. 1398-1405, (1990)

[29]

Scott J, Mandatory trial of labor after cesarean delivery: an alternative viewpoint, Obstet Gynecol, 77, pp. 811-814, (1991)

[30]

Leung AS, Leung EK, Paul RH, Uterine rupture after previous cesarean delivery: maternal and fetal consequences, Am J Obstet Gynecol, 169, pp. 945-950, (1993)

← 1 2 3 4 5 →