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

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