Ulyanovsk Medico-biological Journal

CLINICAL MEDICINE

Download  article

DOI 10.34014/2227-1848-2021-2-57-68

CAESAREAN SECTION: PROBLEMS AND PROSPECTS IN THE REPUBLIC OF CRIMEA

O.P. Miklin1, I.S. Glazkov2, I.B. Glazkova2, Z.S. Rumyantseva1, N.A. Reznichenko1, A.A. Gorbunov1

1 V.I. Vernadsky Crimean Federal University, Simferopol, Russia;

2 Simferopol Clinical Maternity Hospital No. 2, Simferopol, Russia

 

Caesarean section (CS) is a surgical procedure performed only in critical conditions to save the life of a mother and a child. The operation should be performed only if clinically indicated. Recently, the rate of cesarean sections is growing, but the number of deaths is not decreasing.

The purpose of the study is to examine the frequency of abdominal delivery in Simferopol, Simferopol Clinical Maternity Hospital No. 2, to assess the possibilities and reserves for CS reduction in the region.

Methods. The authors used retrospective analysis of birth histories according to Robson classification.

Results. In 2018–2019 the frequency of cesarean sections in Simferopol Clinical Maternity Hospital No. 2 increased by 3 %. It was found out that primigravida and multipara with a uterine scar in the cephalic presentation are a reserve to decrease the indicator. It may also be promising to reduce the incidence of cesarean section in pregnant women with breech presentation.

Keywords: caesarean section, Robson classification, Republic of Crimea.

Conflict of interest. The authors declare no conflict of interest.

 

References

  1. Betrán A.P., Ye J., Moller A.-B. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990–2014. PLoS ONE. 2019; 11 (2): e0148343. Available at: https://www.ncbi.nlm. nih.gov/pmc/articles/PMC4743929 (accessed: March 10, 2020). DOI: 10.1371/journal.pone.0148343.

  2. Singh P., Hashmi G., Swain P.K. High prevalence of cesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India. BMC Public Health. 2018. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946478 (accessed: March 10, 2020). DOI: 10.1186/s12889-018-5533-3.

  3. Alonso B.D., da Silva F.M.B., Latorre M. Do R.D. Caesarean birth rates in public and privately funded hospitals: a cross-sectional study. Revista de Saúde Pública. 2017; 51: 101. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697922 (accessed: March 10, 2020). DOI: 10.11606/S1518-8787.2017051007054.

  4. Loke A.Y., Davies L., Li S.F. Factors influencing the decision that women make on their mode of delivery the Health Belief Model. BMC Health Serv Res. 2015; 15: 274. Available at: https://www.ncbi.nlm.nih. gov/pmc/articles/PMC4506759 (accessed: March 10, 2020). DOI: 10.1186/s12913-015-0931-z.

  5. Dina Samir G.D., Lamiaa ELsayed F., Amany Hussein R. Factors influencing the decision-making process regarding mode of delivery among women attending primary health care units in Ismailia district. International Journal of Advanced Community Medicine. 2019; 2 (2): 34–42.

  6. Olenev A.S., Vuchenovich Yu.D., Novikova V.A. Razryv matki i riski near miss [Uterine rupture and near miss risks]. Akusherstvo i ginekologiya: novosti mneniya, obuchenie. 2019; 7 (3): 55–63. DOI: 10.24411/2303-9698-2019-13008 (in Russian).

  7. Betran A.P., Torloni M.R. What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. Reprod. Health. 2015; 12 (1): 57. Available at: https://www.ncbi. nlm.nih.gov/pmc/articles/PMC4496821 (accessed: March 10, 2020). DOI: 10.1186/s12978-015-0043-6.

  8. Ye J., Zhang J., Mikolajczyk R. Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data. BJOG. 2016; 123 (5): 745–753. DOI: 10.1111/1471-0528.13592.

  9. WHO Statement on Caesarean Section Rates. World Health Organization. 2015: 1–8. Available at: https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1 (accessed: March 10, 2020).

  10. Xiao-Yu Pan, Yu-Ping Wang, Zheng Zheng. A Marked Increase in Obstetric Hysterectomy for Placenta. Chin. Med. J. (Engl). 2015; 128 (16): 2189–2193. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717972 (accessed: 10.03.2020). DOI: 10.4103/0366-6999.162508.

  11. Maswime S., Buchmann E. A systematic review of maternal near miss and mortality due to postpartum hemorrhage. Int. J. Gynaecol. Obstet. 2017; 137 (1): 1–7. Available at: https://www.ncbi.nlm. nih.gov/pubmed/28099749 (accessed: 10.03.2020). DOI: 10.1002/ijgo.12096.

  12. Sotunsa J.O., Adeniyi A.A., Imaralu J.O. Maternal near‐miss and death among women with postpartum haemorrhage: a secondary analysis of the Nigeria Near‐miss and Maternal Death Survey. BJOG. 2019; 126, Suppl 3: 19–25. Available at: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.15624 (accessed: March 10, 2020). DOI: 10.1111/1471-0528.15624.

  13. Hasegawa J., Katsurag, S., Tanaka H. Decline in maternal death due to obstetric hemorrhage between 2010 and 2017 in Japan. Scientific Reports. 2019; 9 (1): 11026. Available at: https://pubmed.ncbi.nlm.nih.gov/31363105 (accessed: March 10, 2020). DOI: 10.1038/s41598-019-47378-z.

  14. Nousheen Khan, Sweety Kumari, Shalini Malhotra, Muna Khalfan. Placenta Percreta Causing Maternal Collapse due to Uterine Rupture in Third Trimester of Pregnancy: Case Report. Biomedical Journal of Scientific & Technical research. 2019; 21, Issue 2: 15671–15673. Available at: https://biomedres.us/pdfs/BJSTR.MS.ID.003563.pdf (accessed: March 10, 2020). DOI: 10.26717/BJSTR.2019.21.003563.

  15. Smith V., Gallagher L., Carroll M. Antenatal and intrapartum interventions for reducing caesarean section, promoting vaginal birth, and reducing fear of childbirth: An overview of systematic reviews. PLoS One. 2019; 14 (10). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812784 (accessed: March 10, 2020). DOI: 10.1371/journal.pone.0224313.

Received 02 April 2021; accepted 28 May 2021.

 

Information about the authors

Miklin Oleg Petrovich, Candidate of Sciences (Medicine), Associate Professor, V.I. Vernadsky Crimean Federal University. 295007, Russia, Simferopol, Akademik Vernadsky Ave., 4; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0001-7739-4608

Glazkov Il'ya Sergeevich, Doctor of Sciences (Medicine), Professor, Chief Physician, Simferopol Clinical Maternity Hospital No. 2. 295034, Russia, Simferopol, B. Khmel'nitsky St., 16; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-7432-5161

Glazkova Irina Borisovna, Doctor of Sciences (Medicine), Associate Professor, Simferopol Clinical Maternity Hospital No. 2. 295034, Russia, Simferopol, B. Khmel'nitsky St., 16; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-3636-9729

Rumyantseva Zoya Sergeevna, Candidate of Sciences (Medicine), Associate Professor, Vice Head of the Department of Obstetrics, Gynecology and Perinatology No. 1, V.I. Vernadsky Crimean Federal University. 295007, Russia, Simferopol, Akademik Vernadsky Ave., 4; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-1711-0210

Reznichenko Natal'ya Anatol'evna, Doctor of Sciences (Medicine), Associate Professor, V.I. Vernadsky Crimean Federal University. 295007, Russia, Simferopol, Akademik Vernadsky Ave., 4; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-00030-3396-1046

Gorbunov Aleksandr Andreevich, 4th year student, V.I. Vernadsky Crimean Federal University. 295007, Russia, Simferopol, Akademik Vernadsky Ave., 4; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-2886-6178

 

For citation

Miklin O.P., Glazkov I.S., Glazkova I.B., Rumyantseva Z.S., Reznichenko N.A., Gorbunov A.A. Kesarevo sechenie: problemy i perspektivy v Respublike Krym [Caesarean section: Problems and prospects in the Republic of Crimea]. Ul'yanovskiy mediko-biologicheskiy zhurnal. 2021; 2: 57–68. DOI: 10.34014/2227-1848-2021-2-57-68 (in Russian).

 

Скачать статью

УДК 618.5-089.888.61(470-924.71)

DOI 10.34014/2227-1848-2021-2-57-68

КЕСАРЕВО СЕЧЕНИЕ: ПРОБЛЕМЫ И ПЕРСПЕКТИВЫ В РЕСПУБЛИКЕ КРЫМ

О.П. Миклин1, И.С. Глазков2, И.Б. Глазкова2, З.С. Румянцева1, Н.А. Резниченко1, А.А. Горбунов1

1 Медицинская академия им. С.И. Георгиевского ФГАОУ ВО «Крымский федеральный университет им. В.И. Вернадского», г. Симферополь, Россия;

2 ГБУЗ РК «Симферопольский клинический родильный дом № 2», г. Симферополь, Россия

 

Операция кесарева сечения является методом, проводимым только при угрожающих состояниях с целью спасения жизни матери и ребенка. Операция должна выполняться только при строгих показаниях врача. В последнее время тенденция к родоразрешению путем кесарева сечения нарастает, однако число летальных исходов не уменьшается.

Цель. Определение частоты абдоминального родоразрешения в г. Симферополь на примере ГБУЗ РК «Симферопольский клинический родильный дом № 2» и оценка возможностей и резервов ее снижения в регионе.

Материалы и методы. Ретроспективный анализ историй родов по классификации Робсона.

Результаты. Частота кесарева сечения в ГБУЗ РК «Симферопольский клинический родильный дом № 2» в течение 2 лет возросла на 3 %. Было установлено, что резервом снижения данного показателя являются первобеременные и повторнородящие с рубцом на матке и с плодом в головном предлежании. Перспективным может быть также снижение частоты кесарева сечения у беременных с тазовым предлежанием.

Ключевые слова: кесарево сечение, классификация Робсона, Республика Крым.

 

Литература

  1. Betrán A.P., Ye J., Moller A.-B. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990–2014. PLoS ONE. 2019; 11 (2): e0148343. URL: https://www.ncbi. nlm.nih.gov/pmc/articles/PMC4743929 (дата обращения: 10.03.2020). DOI: 10.1371/journal.pone.0148343.

  2. Singh P., Hashmi G., Swain P.K. High prevalence of cesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India. BMC Public Health. 2018. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946478 (дата обращения: 10.03.2020). DOI: 10.1186/s12889-018-5533-3.

  3. Alonso B.D., da Silva F.M.B., Latorre M. Do R.D. Caesarean birth rates in public and privately funded hospitals: a cross-sectional study. Revista de Saúde Pública. 2017; 51: 101. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697922 (дата обращения: 10.03.2020). DOI: 10.11606/S1518-8787.2017051007054.

  4. Loke A.Y., Davies L., Li S.F. Factors influencing the decision that women make on their mode of delivery the Health Belief Model. BMC Health Serv Res. 2015; 15: 274. URL: https://www.ncbi.nlm. nih.gov/pmc/articles/PMC4506759 (дата обращения: 10.03.2020). DOI: 10.1186/s12913-015-0931-z.

  5. Dina Samir G.D., Lamiaa ELsayed F., Amany Hussein R. Factors influencing the decision-making process regarding mode of delivery among women attending primary health care units in Ismailia district. International Journal of Advanced Community Medicine. 2019; 2 (2): 34–42.

  6. Оленев А.С., Вученович Ю.Д., Новикова В.А. Разрыв матки и риски near miss. Акушерство и гинекология: новости мнения, обучение. 2019; 7 (3): 55–63. DOI: 10.24411/2303-9698-2019-13008.

  7. Betran A.P., Torloni M.R. What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. Reprod. Health. 2015; 12 (1): 57. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4496821 (дата обращения: 10.03.2020). DOI: 10.1186/s12978-015-0043-6.

  8. Ye J., Zhang J., Mikolajczyk R. Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data. BJOG. 2016; 123 (5): 745–753. DOI: 10.1111/1471-0528.13592.

  9. WHO Statement on Caesarean Section Rates. World Health Organization. 2015: 1–8. URL: https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1 (дата обращения: 10.03.2020).

  10. Xiao-Yu Pan, Yu-Ping Wang, Zheng Zheng. A Marked Increase in Obstetric Hysterectomy for Placenta. Chin. Med. J. (Engl). 2015; 128 (16): 2189–2193. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717972 (дата обращения: 10.03.2020). DOI: 10.4103/0366-6999.162508.

  11. Maswime S., Buchmann E. A systematic review of maternal near miss and mortality due to postpartum hemorrhage. Int. J. Gynaecol. Obstet. 2017; 137 (1): 1–7. URL: https://www.ncbi.nlm.nih.gov/pubmed/28099749 (дата обращения: 10.03.2020). DOI: 10.1002/ijgo.12096.

  12. Sotunsa J.O., Adeniyi A.A., Imaralu J.O. Maternal near‐miss and death among women with postpartum haemorrhage: a secondary analysis of the Nigeria Near‐miss and Maternal Death Survey. BJOG. 2019; 126, Suppl 3: 19–25. URL: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.15624 (дата обращения: 10.03.2020). DOI: 10.1111/1471-0528.15624.

  13. Hasegawa J., Katsurag, S., Tanaka H. Decline in maternal death due to obstetric hemorrhage between 2010 and 2017 in Japan. Scientific Reports. 2019; 9 (1): 11026. URL: https://pubmed.ncbi. nlm.nih.gov/31363105 (дата обращения: 10.03.2020). DOI: 10.1038/s41598-019-47378-z.

  14. Nousheen Khan, Sweety Kumari, Shalini Malhotra, Muna Khalfan. Placenta Percreta Causing Maternal Collapse due to Uterine Rupture in Third Trimester of Pregnancy: Case Report. Biomedical Journal of Scientific & Technical research. 2019; 21, Is. 2: 15671–15673. URL: https://biomedres.us/pdfs/ BJSTR.MS.ID.003563.pdf (дата обращения: 10.03.2020). DOI: 10.26717/BJSTR.2019.21.003563.

  15. Smith V., Gallagher L., Carroll M. Antenatal and intrapartum interventions for reducing caesarean section, promoting vaginal birth, and reducing fear of childbirth: An overview of systematic reviews. PLoS One. 2019; 14 (10). URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812784 (дата обращения: 10.03.2020). DOI: 10.1371/journal.pone.0224313.

Поступила в редакцию 02.04.2021; принята 28.05.2021.

 

Авторский коллектив

Миклин Олег Петрович – кандидат медицинских наук, доцент, Медицинская академия им. С.И. Георгиевского ФГАОУ ВО «Крымский федеральный университет им. В.И. Вернадского». 295007, Россия, г. Симферополь, пр. Академика Вернадского, 4; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0001-7739-4608

Глазков Илья Сергеевич – доктор медицинских наук, профессор, главный врач ГБУЗ РК «Симферопольский клинический родильный дом № 2». 295034, Россия, г. Симферополь, ул. Б. Хмельницкого, 16; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-7432-5161

Глазкова Ирина Борисовна – доктор медицинских наук, доцент, врач, ГБУЗ РК «Симферопольский клинический родильный дом № 2». 295034, Россия, г. Симферополь, ул. Б. Хмельницкого, 16; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-3636-9729

Румянцева Зоя Сергеевна – кандидат медицинских наук, доцент, и.о. заведующего кафедрой акушерства, гинекологии и перинатологии № 1, Медицинская академия им. С.И. Георгиевского ФГАОУ ВО «Крымский федеральный университет им. В.И. Вернадского». 295007, Россия, г. Симферополь, пр. Академика Вернадского, 4; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-1711-0210

Резниченко Наталья Анатольевна – доктор медицинских наук, профессор, Медицинская академия им. С.И. Георгиевского ФГАОУ ВО «Крымский федеральный университет им. В.И. Вернадского». 295007, Россия, г. Симферополь, пр. Академика Вернадского, 4; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-00030-3396-1046

Горбунов Александр Андреевич – студент 4 курса, Медицинская академия им. С.И. Георгиевского ФГАОУ ВО «Крымский федеральный университет им. В.И. Вернадского». 295007, Россия, г. Симферополь, пр. Академика Вернадского, 4; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-2886-6178

 

Образец цитирования

Миклин О.П., Глазков И.С., Глазкова И.Б., Румянцева З.С., Резниченко Н.А., Горбунов А.А. Кесарево сечение: проблемы и перспективы в Республике Крым. Ульяновский медико-биологический журнал. 2021; 2: 57–68. DOI: 10.34014/2227-1848-2021-2-57-68.