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首页> 外文期刊>Journal of women’s health >What Are Optimal Cesarean Section Rates in the US and How Do We Get There? A Review of Evidence-Based Recommendations and Interventions
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What Are Optimal Cesarean Section Rates in the US and How Do We Get There? A Review of Evidence-Based Recommendations and Interventions

机译：我们在美国的最佳剖宫产率是什么以及我们如何到达那里？ 审查循证建议和干预措施

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摘要

Cesarean sections (CSs) are the most commonly performed surgical procedures in the world today. Global epidemiological studies from the last decade suggest that the optimal CS rates in developed countries exist somewhere between 15% and 19%. Despite these findings, CS rates in the United States have remained stable at slightly over 32% over the past 10 years. Using primary and secondary literature published from 2010 to 2015, this review discusses how optimal CS rates were developed. In addition, we define a category of potentially avoidable CS (i.e., those conducted on nulliparous low-risk women who present with vertex infants at term) and explore how CS in this population appear to be one of the main drivers of high CS rates overall. The institutional, provider, and patient-related factors, which may be related to higher-than-recommended rates of CS, particularly those conducted in low-risk women, will be discussed. This review will then delve into clinician and patient-oriented interventions that have been shown to effectively reduce the rate of potentially avoidable CS. Our analysis showed that large-scale, multifaceted interventions that include audit and feedback cycles as well as peer review strategies were the most effective in decreasing rates of potentially avoidable CS. This review concludes with an agenda for future research into interventions that aim to achieve optimal CS rates.
机译：剖宫产（CSS）是当今世界上最常见的手术手术。过去十年的全球流行病学研究表明，发达国家的最佳CS率存在于15％至19％之间。尽管有这些调查结果，但在过去10年中，美国的CS利率仍保持稳定超过32％。本综述，使用从2010年到2015年发布的中小文献，讨论了如何开发最佳CS率。此外，我们还定义了一类潜在的可避免的CS（即，在术语上呈现出顶点婴儿的无血压低风险女性进行的那些），并探讨了这群人群的CS如何成为高CS率的主要驱动因素之一。将讨论制度，提供者和患者相关因素，这些因素可能与高于建议的CS率，特别是在低危妇女中进行的税率相关。然后，该审查将深入研究临床医生和以患者为导向的干预措施，已被证明可以有效降低潜在可避免的CS的速度。我们的分析表明，包括审计和反馈周期以及同行评审策略的大规模，审查策略是最有效的潜在可避免的CS率。该审查总结了未来研究旨在实现最佳CS率的干预措施的议程。

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