摩尔多瓦共和国一家高等院校的剖宫产情况：采用罗布森分类法进行分析

AJOG global reports Pub Date : 2024-11-01 DOI:10.1016/j.xagr.2024.100408

Angela Marian-Pavlenco MD, PhD, Irina Siritanu MD, Tatiana Ribac MD, Valentin Friptu MD, PhD

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引用次数: 0

摘要

背景全球范围内剖宫产率的上升是一个重大的公共卫生问题，也是引起重大争议的原因。尽管多项研究表明，较高的剖宫产率可能与不良的孕产妇和围产期结局有关，但剖宫产的数量仍在持续增加。在摩尔多瓦共和国，剖宫产率从 2012 年的 15.75% 上升至 2022 年的 27.42%。然而，围产期死亡率保持不变，仍为 11.6%。为了了解决定剖宫产率上升趋势的因素，并采取新策略减少不必要的手术分娩，需要一种标准化工具来评估和比较剖宫产率。研究设计这是一项在基希讷乌市立临床医院进行的队列研究。研究对象包括 2017 年、2019 年和 2022 年在市临床医院分娩的 13882 名妇女。所有产妇被分为10个罗布森组，使用6个基本变量（奇偶数、病史中的剖宫产、临产、胎儿数量、胎龄和胎儿表现）。结果总体剖宫产率为 20.02%（2779/13882），从 18.59%（809/4351）显著上升至 21.59%（1134/5252）（P=.0003）。大约三分之一（1099/2279 [39.55%]）的剖宫产是在临产前进行的。在所有研究年份中，第 5 组（957/2779 [34.44%]）是剖宫产的主要贡献者。结论罗布森十组分类系统清晰而详细地记录了剖宫产的趋势。此外，由于罗布森十组分类系统的简便性和排他性，它可以在摩尔多瓦共和国实施。总体剖宫产率的主要贡献者是曾有过剖宫产经历的妇女（第 5 组），其次是第 2 组和第 1 组的无产科妇女。

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Cesarean delivery in a tertiary institution of the Republic of Moldova: analysis using the Robson classification

BACKGROUND

The worldwide increase in the cesarean delivery rate is a major public health concern and cause of significant debate. Although multiple studies have shown that higher cesarean delivery rates may be associated with adverse maternal and perinatal outcomes, the number of cesarean deliveries has been continuously increasing. In the Republic of Moldova, cesarean delivery increased from 15.75% in 2012 to 27.42% in 2022. However, the perinatal mortality remained unchanged at 11.6%. To understand the factors that determine the increasing trend in cesarean delivery and to approach new strategies to reduce unnecessary surgical delivery, a standardized tool is needed to assess and compare cesarean delivery rates.

OBJECTIVE

This study aimed to assess the changes in the rates and trends of cesarean delivery and to evaluate the contribution of different obstetrical populations to overall cesarean delivery rates in the Municipal Clinical Hospital using the Robson classification.

STUDY DESIGN

This was a cohort study conducted at the Municipal Clinical Hospital in Chisinau. The study included 13,882 women who gave birth in 2017, 2019, and 2022 at the Municipal Clinical Hospital. All births were classified into 10 Robson groups, using 6 basic variables (parity, cesarean delivery in medical history, labor onset, number of fetuses, gestational age, and fetal presentation). Statistical data were collected and analyzed using the Epi Info program (version 7.2.1.0; Centers for Disease Control and Prevention, Atlanta, GA).

RESULTS

The overall cesarean delivery rate was 20.02% (2779/13,882), with a significant increase from 18.59% (809/4351) to 21.59% (1134/5252) (P=.0003). Approximately one-third (1099/2279 [39.55%]) of all cesarean deliveries were performed before labor onset. The main contributor in all study years was group 5 (957/2779 [34.44%]). The next valuable group that contributed to the overall cesarean delivery rate was group 2 (393/2779 [14.14%]), followed by group 1 (333/2779 [11.98%]).

CONCLUSION

The Robson Ten-Group Classification System provides a clear and detailed record of the trends in cesarean delivery. In addition, because of the Robson Ten-Group Classification System's simplicity and exclusivity, it can be implemented in the Republic of Moldova. The main contributors to the overall cesarean delivery rate were women with a previous cesarean delivery (group 5), followed by nulliparous women of group 2 and group 1.

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来源期刊

AJOG global reports Endocrinology, Diabetes and Metabolism, Obstetrics, Gynecology and Women's Health, Perinatology, Pediatrics and Child Health, Urology

CiteScore

1.20

自引率

0.00%

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