Limits...
A descriptive analysis of the indications for caesarean section in mainland China.

Liu Y, Li G, Chen Y, Wang X, Ruan Y, Zou L, Zhang W - BMC Pregnancy Childbirth (2014)

Bottom Line: The relaxation of China's "one-child policy" may translate into a greater number of CS because of previous CS delivery.To decrease the CS rate, we should first decrease the rate of CS on maternal request.Appropriate policies and guidelines should be considered to accomplish the goal.

View Article: PubMed Central - PubMed

Affiliation: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China. zhangwy9921@hotmail.com.

ABSTRACT

Background: In recent decades we have observed a remarkable increase in the rate of caesarean section (CS) in both developed and developing countries, especially in China. However, the real reasons for this phenomenon are uncertain. Notably, the number of women requesting elective CS without accepted valid medical indication has also increased, generating a nationwide debate because several studies have shown that this may be the underlying cause of the increase in CS rates observed recently. Therefore, we carried out a multicentre, large-sample, cross-sectional study to describe the CS rate and indications for CS in mainland China during 2011.

Methods: This was a multicentre, large-sample, cross-sectional study of women who delivered infants in 39 hospitals in 14 provinces in China during 2011. We selected 111, 315 deliveries that occurred during 2011, excluding miscarriages or termination of pregnancy before 28 gestational weeks.

Results: The overall rate of CS in mainland China was 54.90%. The most common indication for CS was caesarean delivery on maternal request (CDMR; 28.43%), followed by cephalo-pelvic disproportion (14.08%), fetal distress (12.46%), previous CS (10.25%), malpresentation and breech presentation (6.56%), macrosomia (6.10%) and other indications (22.12%). CDMR accounted for 15.53% of all the deliveries and 28.43% of all CS deliveries in mainland China.

Conclusions: CDMR appears to be a considerable driver behind the increasing CS rate in mainland China. The relaxation of China's "one-child policy" may translate into a greater number of CS because of previous CS delivery. To decrease the CS rate, we should first decrease the rate of CS on maternal request. Appropriate policies and guidelines should be considered to accomplish the goal.

Show MeSH

Related in: MedlinePlus

The five main indications for caesarean section in mainland China.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4269966&req=5

Fig2: The five main indications for caesarean section in mainland China.

Mentions: We selected only the deliveries occurring at ≥37 weeks of gestation (n = 102,424) for the analysis of the indications for CS. As shown in Figure 2, the most common indication for CS was maternal request (28.43%), followed by cephalo-pelvic disproportion (14.08%), fetal distress (12.46%), previous CS delivery (10.25%), malpresentation and breech presentation (6.56%), macrosomia (6.10%) and “other indications” (22.12%). The other indications included prolonged labor (dystocia) (3.6%), oligohydramnios (3.2%), elderly primigravida (2.4%), preeclampsia (2.1%), precious infant (1.8%) and others. In our study we identified additional indications for CS, such as multiple fetuses (0.95%), umbilical cord being wrapped around the neck (0.69%), premature rupture of membrane (0.53%), high myopia (0.47%), combined myoma of uterus and ovarian tumors (0.36%) and gestational diabetes mellitus (0.34%). CDMR accounted for 15.53% of all deliveries and 28.43% of the CS deliveries in mainland China.Figure 2


A descriptive analysis of the indications for caesarean section in mainland China.

Liu Y, Li G, Chen Y, Wang X, Ruan Y, Zou L, Zhang W - BMC Pregnancy Childbirth (2014)

The five main indications for caesarean section in mainland China.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4269966&req=5

Fig2: The five main indications for caesarean section in mainland China.
Mentions: We selected only the deliveries occurring at ≥37 weeks of gestation (n = 102,424) for the analysis of the indications for CS. As shown in Figure 2, the most common indication for CS was maternal request (28.43%), followed by cephalo-pelvic disproportion (14.08%), fetal distress (12.46%), previous CS delivery (10.25%), malpresentation and breech presentation (6.56%), macrosomia (6.10%) and “other indications” (22.12%). The other indications included prolonged labor (dystocia) (3.6%), oligohydramnios (3.2%), elderly primigravida (2.4%), preeclampsia (2.1%), precious infant (1.8%) and others. In our study we identified additional indications for CS, such as multiple fetuses (0.95%), umbilical cord being wrapped around the neck (0.69%), premature rupture of membrane (0.53%), high myopia (0.47%), combined myoma of uterus and ovarian tumors (0.36%) and gestational diabetes mellitus (0.34%). CDMR accounted for 15.53% of all deliveries and 28.43% of the CS deliveries in mainland China.Figure 2

Bottom Line: The relaxation of China's "one-child policy" may translate into a greater number of CS because of previous CS delivery.To decrease the CS rate, we should first decrease the rate of CS on maternal request.Appropriate policies and guidelines should be considered to accomplish the goal.

View Article: PubMed Central - PubMed

Affiliation: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China. zhangwy9921@hotmail.com.

ABSTRACT

Background: In recent decades we have observed a remarkable increase in the rate of caesarean section (CS) in both developed and developing countries, especially in China. However, the real reasons for this phenomenon are uncertain. Notably, the number of women requesting elective CS without accepted valid medical indication has also increased, generating a nationwide debate because several studies have shown that this may be the underlying cause of the increase in CS rates observed recently. Therefore, we carried out a multicentre, large-sample, cross-sectional study to describe the CS rate and indications for CS in mainland China during 2011.

Methods: This was a multicentre, large-sample, cross-sectional study of women who delivered infants in 39 hospitals in 14 provinces in China during 2011. We selected 111, 315 deliveries that occurred during 2011, excluding miscarriages or termination of pregnancy before 28 gestational weeks.

Results: The overall rate of CS in mainland China was 54.90%. The most common indication for CS was caesarean delivery on maternal request (CDMR; 28.43%), followed by cephalo-pelvic disproportion (14.08%), fetal distress (12.46%), previous CS (10.25%), malpresentation and breech presentation (6.56%), macrosomia (6.10%) and other indications (22.12%). CDMR accounted for 15.53% of all the deliveries and 28.43% of all CS deliveries in mainland China.

Conclusions: CDMR appears to be a considerable driver behind the increasing CS rate in mainland China. The relaxation of China's "one-child policy" may translate into a greater number of CS because of previous CS delivery. To decrease the CS rate, we should first decrease the rate of CS on maternal request. Appropriate policies and guidelines should be considered to accomplish the goal.

Show MeSH
Related in: MedlinePlus