Tom 4, Nr 3 (2019)
Praca badawcza (oryginalna)
Opublikowany online: 2019-09-30
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Cięcie cesarskie. Rosnący odsetek i zmiana trendów we wskazaniach
Ginekologia i Perinatologia Praktyczna 2019;4(3):113-122.
Streszczenie
Wstęp. W ostatnich latach na całym świecie zauważalnie wzrósł odsetek cięć cesarskich. Podejmuje się wiele wysiłków, aby zrozumieć to zjawisko, jednym z nich jest analiza zmieniających się na przestrzeni lat wskazań do operacyjnego zakończenia ciąży.
Cel badań. Analiza i porównanie wskazań do cięcia cesarskiego na przestrzeni dziesięciu lat.
Materiały i metody. Grupę badaną stanowiły kobiety rodzące w Klinice Położnictwa i Ginekologii SPSK2 w Szcze¬cinie w latach 2004–2008 i 2014–2018. Spośród 14 112 porodów wyodrębniono te, które odbyły się poprzez cesarskie cięcie. Dokonano analizy 1647 porodów w latach 2004–2008 oraz 4296 w latach 2014–2018. Wska¬zania podzielono na położnicze i pozapołożnicze.
Wyniki. Zaobserwowano wzrost odsetka cięć cesarskich w ciągu dekady — z 26,12% na 55,03%. Średni wiek kobiet, zarówno pierworódek jak i wieloródek istotnie wzrósł. Wśród wskazań położniczych w latach 2004–2008 najczęściej wykonywano cięcie cesarskie z powodu braku postępu porodu (26,9%), w latach 2014–2018 wiodące wskazanie to stan po poprzednim cięciu cesarskim (34,23%). Najczęstsze pozapołożnicze przyczyny operacyj¬nego zakończenia ciąży w latach 2004–2008 to: okulistyczne (43,64%), ortopedyczne (16,36%), kardiologiczne (13,09%), a w latach 2014–2018: psychiatryczne (35,31%) wśród których pojawiło się wcześniej nieobserwowane wskazanie — tokofobia, ortopedyczne (14,42%), i okulistyczne (11,73%).
Wnioski. Odsetek cięć cesarskich wzrósł ponad dwukrotnie na przestrzeni dziesięciu lat. Przebyte w przeszłości cięcie cesarskie jest obecnie dominującym wskazaniem położniczym. Tokofobia staje się istotnym problemem położniczym, zwłaszcza wśród pierworódek.
Słowa kluczowe: poródcięcie cesarskiewskazaniatokofobia
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