Abstract
This study investigated changes in cesarean delivery rate and cesarean indications in 3 county-level hospitals in rural China.
Hospital delivery records in 1997 and 2003 were used to examine the reasons behind the changes. In Chengde County Hospital,
the cesarean delivery rate increased from 28% in 1997 to 54% in 2003. The rate increased from 43% in 1997 to 65% in 2003 in
Anxian County Hospital and Anxian Maternal and Child Health Hospital. The dramatic increase in cesarean delivery in the study
hospitals was associated with a shift from more severe to mild or no clinical indications. The ratio of mild to moderate to
severe hypertension increased substantially. More than half of the cephalopelvic disproportion cases were diagnosed prior
to labor. The majority of nuchal cord cases were diagnosed without fetal distress. Maternal/family request was the number
one cesarean indication in Anxian County Hospital and Anxian MCH Hospital in 2003. Ultrasound evidence of nuchal cord moved
from the ninth ranked indication in 1997 to the second in 2003 in Chengde County Hospital.
Hospital delivery records in 1997 and 2003 were used to examine the reasons behind the changes. In Chengde County Hospital,
the cesarean delivery rate increased from 28% in 1997 to 54% in 2003. The rate increased from 43% in 1997 to 65% in 2003 in
Anxian County Hospital and Anxian Maternal and Child Health Hospital. The dramatic increase in cesarean delivery in the study
hospitals was associated with a shift from more severe to mild or no clinical indications. The ratio of mild to moderate to
severe hypertension increased substantially. More than half of the cephalopelvic disproportion cases were diagnosed prior
to labor. The majority of nuchal cord cases were diagnosed without fetal distress. Maternal/family request was the number
one cesarean indication in Anxian County Hospital and Anxian MCH Hospital in 2003. Ultrasound evidence of nuchal cord moved
from the ninth ranked indication in 1997 to the second in 2003 in Chengde County Hospital.
- Content Type Journal Article
- Pages 1-7
- DOI 10.1007/s10995-011-0913-7
- Authors
- Cheng Qin, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS K-23, Atlanta, GA 30341, USA
- Min Zhou, Women’s and Children’s Health Center, Peking University, Beijing, People’s Republic of China
- William M. Callaghan, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS K-23, Atlanta, GA 30341, USA
- Samuel F. Posner, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Jun Zhang, National Institute of Child Health and Human Development, National Institute of Health, Rockville, MD, USA
- Cynthia J. Berg, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS K-23, Atlanta, GA 30341, USA
- Gengli Zhao, Women’s and Children’s Health Center, Peking University, Beijing, People’s Republic of China
- Journal Maternal and Child Health Journal
- Online ISSN 1573-6628
- Print ISSN 1092-7875