Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC1796610.15690/vramn17966OBSTETRICS AND GYNECOLOGY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ АКУШЕРСТВА И ГИНЕКОЛОГИИResearch ArticleReasons for the Increase and Ways to Reduce the Frequency of Cesarean Sections in Modern ObstetricsПричины роста и пути снижения частоты кесарева сечения в современном акушерствеhttps://orcid.org/0000-0001-8572-19715058-7295BaevOleg R.БаевОлег Р.
Russian Federation

MD, PhD, Professor

д.м.н., профессор

metod_obsgyn@hotmail.comResearch Center for Obstetrics, Gynecology and PerinatologyНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова28122024131220247953853921503202413102024Copyright ©; 2024, "Paediatrician" Publishers LLCCopyright ©; 2024, Издательство "Педиатръ"2024"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/17966

The progressive increase in the number of cesarean sections, which is not accompanied by a decrease in the perinatal mortality rate, is an urgent problem not only in obstetrics, but in the health care system in general. The frequency of operative delivery is influenced by both medical and non-medical factors. Moreover, the frequency varies across regions of the world and countries with different levels of economic development. At the present stage, the increase in the number of surgical deliveries in developed countries is due to changes in population health indicators (age, morbidity). The attention of WHO and associations of obstetricians and gynecologists is drawn to the development of measures to stabilize and reduce the frequency of cesarean sections. However, the proposed measures to reduce it through administration in obstetric hospitals and non-medical measures do not have an effect. There is evidence of an increase in the incidence of complications for the mother and fetus when indications for cesarean section are limited. A safe reduction in the frequency of caesarean sections is possible only with an integrated approach, including new solutions that improve the quality of medical care in general (social measures to support families, optimization of medical processes, introduction of decision support systems, improvement of medical technologies for pregnancy and childbirth).

Прогрессирующий рост количества операций кесарева сечения, который не сопровождается снижением показателя перинатальной смертности, является актуальной проблемой не только акушерства, но и системы здравоохранения в целом. На частоту оперативного родоразрешения оказывают влияние как медицинские, так и немедицинские факторы. При этом частота варьирует по регионам мира, странам с разным уровнем экономического развития. На современном этапе увеличение количества оперативных родоразрешений в развитых странах обусловлено изменением популяционных показателей здоровья (возраста, заболеваемости). Внимание Всемирной организации здравоохранения и ассоциаций акушеров-гинекологов обращено на разработку мер по стабилизации и снижению частоты кесарева сечения. Однако предлагаемые меры ее снижения путем администрирования в акушерских стационарах и мероприятий немедицинского характера не дают эффекта. Имеются данные об увеличении частоты осложнений для матери и плода при ограничении показаний к кесареву сечению. Безопасное снижение частоты кесарева сечения возможно только при комплексном подходе, включающем новые решения, которые улучшают качество оказания медицинской помощи в целом (социальные меры поддержки семей, оптимизацию медицинских процессов, внедрение систем поддержки принятия решения, совершенствование медицинских технологий ведения беременности и родов).

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