| Abstract | UVOD: Carski rez jedna je od najčešće izvođenih operacija kod žena u cijelom svijetu, pri kojoj se otvaranjem trbušne šupljine vade dijete i posteljica iz maternice. Stope carskih rezova svake su godine u porastu, a ukupni postotak carskih rezova u svijetu je 2021. godine bio je, prema Svjetskoj zdravstvenoj organizaciji, 21,1%. Osim zdravstvenih indikacija, na učestalost carskog reza imaju utjecaj i bolji financijski, društveni i gospodarski status trudnice te zahtjev rodilje za carskim rezom. Tokofobiju definiramo kao strah od porođaja. Može biti primarna, kod nulipara, te sekundarna, kod žena koje su rađale, a rasprostranjenost tokofobije u svijetu 2017. godine bila je 14%.
CILJ ISTRAŽIVANJA: Glavni cilj istraživanja bio je utvrditi najčešću indikaciju za dovršavanje porođaja carskim rezom u Kliničkom bolničkom centru Rijeka. Ostali ciljevi istraživanja bili su utvrditi stopu carskih rezova po godinama i usporediti ih te utvrditi učestalost carskih rezova u ukupnom broju svih porođaja u razdoblju istraživanja. Zadnji cilj bio je utvrditi zastupljenost tokofobije kao indikacije za dovršavanje porođaja carskim rezom među ostalim indikacijama.
MATERIJALI I METODE: Istraživanje je provedeno na Klinici za ginekologiju i porodništvo u Kliničkom bolničkom centru Rijeka gdje su se retrospektivno uzeli podatci iz medicinske dokumentacije u vremenskom razdoblju od 1. siječnja 2020. do 31. prosinca 2022. godine, a dobiveni podatci prikazani su pomoću tablica i grafova. Hipoteze su testirane metodama deskriptivne statistike. Statistička obrada podataka provela se pomoću programa Microsoft Excel i Statistica 14.0.0.15 (TIBCO Software Inc.).
REZULTATI: U razdoblju istraživanja bilo je sveukupno 6814 porođaja od kojih je 1979 odnosno 29,04% dovršeno carski rezom. Stopa carskih rezova po godinama je u porastu, a iznosila je 27,67% za 2020., 28,99% za 2021. i 30,61% za 2022. godinu. Indikacije za dovršavanje porođaja carskim rezom bile su podijeljene u 11 kategorija, a najčešća indikacija bila je distocija sa 28,60%. Fetalna patnja kao indikacija bila je na trećem mjestu po učestalosti sa 20,72%. Najmanje zastupljena indikacija bila je tokofobija sa sveukupno 3 slučaja odnosno 0,15%.
ZAKLJUČAK: Provjerene su hipoteze te su samo dvije od ukupno četiri hipoteze potvrđene. Rezultati su pokazali da je najčešća indikacija distocija, a tek nakon nje prethodni carski rez i fetalna patnja. Temeljem rezultata dokazalo se kako je stopa carskih rezova po godinama u 2020., 2021. i 2022. godini u konstantnom porastu. Također se dokazalo kako je sveukupna stopa carskih rezova u sve tri godine 4,04% veća nego očekivano. Potvrđeno je da je tokofobija vrlo malo zastupljena među ostalim indikacijama, ali svakako nije zanemariva. |
| Abstract (english) | INTRODUCTION: Cesarean section is one of the most frequently performed operations in women all over the world, where the child and placenta are removed from the uterus by opening the abdominal cavity. Cesarean section rates are increasing every year, and the overall percentage of C-sections in the world in 2021 was 21,1%, according to the World Health Organization. In addition to health indications, the frequency of cesarean sections is also influenced by the better financial, social and economic status of the pregnant women and the request for C-section by them. Tocophobia can be defined as the fear of childbirth. It can be primary, in nulliparous women, and secondary, in women who have given birth, and the prevalence of tocophobia in the world in 2017 was 14%.
OBJECTIVE: The main objective of the research was to determine the most common indication for completion of childbirth by cesarean section in the Clinical Hospital Center Rijeka. Other objectives of the research were to determine the rate of cesarean sections by year and to compare them, as well as to determine the rate of cesarean sections in the total number of all births in the research period. The last objective was to determine the prevalence of tocophobia as an indication for cesarean delivery among other indications.
MATERIALS AND METHODS: The research was conducted at the Clinic for Gynecology and Obstetrics at the Clinical Hospital Center Rijeka, where data from medical records was retrospectively taken in the period of January 1, 2020 to December 31, 2022, and the obtained data was presented using tables and graphs. Hypotheses were tested using descriptive statistics methods. Statistical data processing was performed using Microsoft Excel and Statistica 14.0.0.15 (TIBCO Software Inc.).
RESULTS: In the research period, there were a total of 6814 childbirths, of which 1979 or 29,04% were completed by cesarean section. The rate of cesarean section by year is increasing, and was 27,67% for 2020, 28,99% for 2021 and 30,61% for 2022. Indications for cesarean delivery were divided into 11 categories, and the most common indication was dystocia with 28,60%. Fetal distress as an indication was in third place in terms of frequency with 20,72%. The lease prevalent indication was tocophobia with a total of 3 cases, or 0,15%.
CONCLUSION: The hypotheses were tested and only two of the four hypotheses were confirmed. The results showed that the most common indication was dystocia, followed by previous cesarean section and fetal distress. Based on the results, it was proven that the rate of cesarean sections by year in 2020, 2021 and 2022 in constantly increasing. It was also proven that the overall rate of C-sections in all three years was 4,04% higher than expected. It has been confirmed that tocophobia is barely represented among other indications, but it is certainly not negligible. |
