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目的:探讨剖宫产与产妇及围生儿死亡率的关系。方法:对1518例剖宫产指征和结局进行回顾性分析。结果:我院2012年剖宫产率为56.3%,与剖宫产有关的产妇死亡2例,死亡率为1.31‰,与剖宫产有关的围生儿死亡18例,死亡率为11.57‰。与同期经阴道分娩围生儿死亡21例,死亡率为17.81‰。两者无明显差异。重度子痫前期、胎盘早剥,中央性前置胎盘剖宫产产妇死亡率为0,围生儿死亡2例,而阴道分娩产妇死亡为1例,围生儿死亡8例,两者有显著差异。结论:剖宫产可以大大降低某些高危妊娠的母婴死亡率,但剖宫产率过高,并不能降低母婴死亡率,反而会引起一系列母婴远期不良并发症,只有提高阴道分娩安全性,正确处理产程,严格掌握剖宫产指征,才能降低剖宫产率,提高产科质量。
Objective: To investigate the relationship between cesarean section and maternal and perinatal mortality. Methods: 1518 cesarean indications and outcomes were retrospectively analyzed. Results: The rate of cesarean section in our hospital in 2012 was 56.3%. There were 2 maternal deaths associated with cesarean section with a mortality rate of 1.31 ‰. There were 18 cases of perinatal deaths associated with cesarean section with a mortality rate of 11.57 ‰. 21 cases of perinatal childbirth with vaginal delivery during the same period, the mortality rate was 17.81 ‰. No significant difference between the two. Severe preeclampsia, placental abruption, central placenta previa cesarean section maternal mortality rate was 0, 2 cases of perinatal death, while maternal death was 1 case of vaginal delivery, perinatal death in 8 cases, both were significant difference. Conclusion: Cesarean section can greatly reduce maternal and infant mortality in some high-risk pregnancies. However, high cesarean section rate can not reduce maternal and infant mortality, but will cause a series of adverse long-term maternal and infant complications, Labor safety, correct handling of labor, strict control of cesarean indications, in order to reduce the rate of cesarean section and improve the quality of obstetrics.