분만방법으로서 제왕절개술의 빈도 및 적응증에 대한 연구(1982년 - 1996년) = A Clinical Study on Incidence and Indication of Cesarean Section

다국어 초록 (Multilingual Abstract)

Objective : Our purpose of this study was to determine the incidence and indication of cesarean section in order to evaluate how rapidly increased cesarean section rate influenced in the trend of delivery.
Method : The study was undertaken for the clinical evaluation on the patients who had been admitted and delivered at Soonchunhyang Kumi Hospital from January, 1982 to December, 1996.
Result : The result were as follows :
1. Of the total deliveries, overall incidence of cesarean section was 18.0%, of which the incidence of primary cesarean section was 67.7% and that of repeat cesarean section was 32.3%. The cesarean section rate was 9.1% in 1982, 11.1% in 1887, 21.1% in 1993 and 30.1% in 1996, which shows a tendency to gradual increment.
2. Among the indication for cesarean section, the repeat cesarean section alone was the most common.
3. The repeat cesarean section rate was 27.0% in 1982 and 41.8% in 1996, which shows a tendency to marked increment.
4. The indication for primary cesarean section were cephalopelvic disproportion(53.7%), breech(21.6%), fetal distress(10.3%), placenta previa(4.2%), pregnancy induced hypertension(5.0%) and miscellaneous(5.3%).
Conclusion : This results suggest that repeat cesarean section and those performed for labor dystocia together account for approximately half of all such operation. Unless the primary cesarean rate is reduce, an important reduction in overall cesarean rate is unlikely. Therefore efforts to encourage vaginal birth after a previous cesarean and restricting cesareans for labor dystocia to women who meet strictly defined criteria appear to be the most productive approach to lowering the cesarean rate.