International differences in the use of obstetric interventions.
International differences in the use of obstetric interventions.
复制标题
产科干预措施使用的国际差异。
DOI：
10.1001/jama.1990.03440240076019
复制
发表时间：
1990
期刊：
影响因子：
--
通讯作者：
F. Notzon
中科院分区：
文献类型：
--
作者：
F. Notzon
本研究调查了1975年至1986年21个国家剖宫产率和14个国家阴道手术分娩率的现状和趋势。各国的产科实践存在巨大差异，剖宫产率从每100例住院分娩中的32例（巴西）到7例（捷克斯洛伐克）不等，阴道手术率从每100例住院分娩中的16例（加拿大）到2例（捷克斯洛伐克）不等。在大多数国家，剖宫产率随着阴道手术率的下降而上升，但也存在一些重要的例外。比较两种可以客观诊断的分娩和分娩并发症（多胎和臀位分娩）的剖宫产率表明，从1980年到1985年，几乎每个国家的剖宫产率都急剧上升。对1985年全国干预率和出生结果测量值的比较发现，两者之间没有显著关系。虽然这种生态学比较充其量是不完美的，但这确实表明，尽管剖腹产率很低，但在某些人群中，早期婴儿死亡率可以达到较低水平。
This study investigated current levels and trends between 1975 and 1986 in the rates of cesarean section in 21 countries and of operative vaginal delivery in 14 countries. Sharp differences in national obstetric practice were found, with cesarean rates ranging from a high of 32 (Brazil) to 7 (Czechoslovakia) per 100 hospital deliveries, and operative vaginal rates from 16 (Canada) to 2 (Czechoslovakia) per 100 hospital deliveries. For most countries, rates of cesarean section have risen as operative vaginal rates have fallen, but some important exceptions exist. A comparison of cesarean section rates for two complications of labor and delivery that can be objectively diagnosed, multiple births and breech delivery, demonstrates that cesarean section rates for these complications rose sharply in almost every country from 1980 to 1985. A comparison of 1985 national rates of intervention and measures of birth outcome found no significant relationship between the two. While such ecological comparisons are imperfect at best, this does indicate that low levels of early infant mortality can be achieved in some populations despite a low rate of cesarean deliveries.