For medical professionals only
Don't choose caesarean section directly because you are worried about "circumferential caesarean section"
When discussing the way of delivery at 36 weeks, many people will choose caesarean section because they are worried about this worry, and one of the common reasons is to worry about "circumvention", which is the so-called "second stubble crime".
In fact, these worries are a bit too worried, the probability of "circumference and caesarean section" is really not so high, at least in hospitals with better delivery room management, the probability of "circumference and caesarean section" is really not high.
Taking my hospital as an example, in order to reduce everyone's worries, rest assured to go to a vaginal delivery, vigorously promote and improve the analgesia rate of delivery, control the rate of transital caesarean section, and reduce the rate of perineal incision.
For a long time, the probability of "cissection" in our hospital was only 1%-2%, which is also a rather difficult thing as a hospital with more than 30,000 births.
Although this is the case, everyone's feelings will still be different, and some people will also put forward their own evidence, thinking that the probability of forward sectioning is not low, which may mainly exist in the following problems.
1
The definition of cis-section is different
There is no uniform standard and definition of circumference. In order to do quality control, our hospital has unified the definition and standard of shun section.
The so-called transit caesarean section, that is, originally intended to be born by themselves, with regular contractions (may be natural birth, may also be induced labor), the uterine opening is also gradually increasing, but because the child can not be born, the mother has fever and other abnormalities, or the fetal heart rate abnormality on the way, the fetal intrauterine distress occurs, and it is necessary to open a caesarean section.
As for how large the uterine opening is included in the scope of the circumferential section, we chose 3 cm.
▌ Why 3 cm?
When examining the opening of the uterine opening, the judgment will be very different between different doctors.
1 cm and 2 cm often can not be well distinguished, the same patient in labor, some doctors say 1 cm, some say 2 cm, some women do not even have uterine contractions, go to check the uterine opening, some doctors will also say that there are 1-2 cm.
But when it reaches 3 centimeters, everyone's judgment will basically not be too different and controversial.
Therefore, we define transit caesarean section as regular contractions, formal labor, and the uterine opening is more than 3 centimeters larger, before this, it is actually impossible to judge whether the formal labor enters the labor process.
If there is no formal delivery, a cesarean section is done, which in principle is not considered a transit caesarean section.
2
Failure to induce labour is not a metasection
Many people feel that the proportion of circumferential caesarean section is relatively high, and it may be that the failure to induce labor is also counted as a circumferential caesarean section. The induction of labor mentioned here is the normal induction of labor with a good fetal condition, not the induction of birth in family planning as everyone imagines, nor the induction of stillbirth.
Usually, the probability of failure of induction of labor is about 10%-20%, depending on the hospital, the doctor, and also the induction program.
In general, the probability of failure of induction of labor will usually exceed 10%, but in hospitals and delivery rooms with better management, the failure rate of induction of labor is single digits, not more than 10%, and the fluctuation range of this data in different hospitals is still quite large.
If the failure of induction of labor is also considered to be a shunna section, this proportion is not low.
3
Observer bias
Observer bias (bias) refers to people's preference for observing the desired outcome of their own hearts, which is different from the objective reality and bias.
That is, if you care a lot about circumference, you will end up seeing more ciss-section stories and cases, even though the objective data does not support the idea that ciss-sections are highly proportioned.
Pregnant mothers often discuss cesarean sections with me, and because of this concern, they will ask for selective caesarean sections to avoid the sin of second stubble.
In order to support my own point of view, I told me that there are many cases of shunna in the group of mothers around me, and they are all famous and surnamed, and I have begun to mutter.
But in fact, the rate of transit caesarean section in our hospital, that is, the probability of cissection by caesarean section, is about 4%, although it has increased compared with before, but it is still a small probability event.
▌Why do you feel that there are so many circumferential sections around you?
This is usually a person who prefers to talk about their experience, and most people who have had a smooth birth will not take the initiative to share their smooth delivery process.
It's a bit like the Internet, where people who don't do anything are not going online to tell stories, vent, and complain.
summary
The above is only the proportion of our hospital's circumference, does not mean that other hospitals are the same, if you are not at ease, you may wish to ask your obstetric doctor, you will give birth to the hospital's circumference and caesarean section probability is what is the probability.
Source of this article: Dr. Duan Tao
This article is written by Duan Tao
Editor-in-Charge: Ichikawa