Document Detail


Cesarean delivery outcomes from the WHO global survey on maternal and perinatal health in Africa.
MedLine Citation:
PMID:  19782977     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the association between cesarean delivery rates and pregnancy outcomes in African health facilities. METHODS: Data were obtained from all births over 2-3 months in 131 facilities. Outcomes included maternal deaths, severe maternal morbidity, fresh stillbirths, and neonatal deaths and morbidity. RESULTS: Median cesarean delivery rate was 8.8% among 83439 births. Cesarean deliveries were performed in only 95 (73%) facilities. Facility-specific cesarean delivery rates were influenced by previous cesarean, pre-eclampsia, induced labor, referral status, and higher health facility classification scores. Pre-eclampsia increased the risks of maternal death, fresh stillbirths, and severe neonatal morbidity. Adjusted emergency cesarean delivery rate was associated with more fresh stillbirths, neonatal deaths, and severe neonatal morbidity--probably related to prolonged labor, asphyxia, and sepsis. Adjusted elective cesarean delivery rate was associated with fewer perinatal deaths. CONCLUSION: Use of cesarean delivery is limited in the African health facilities surveyed. Emergency cesareans, when performed, are often too late to reduce perinatal deaths.
Authors:
Archana Shah; Bukola Fawole; James Machoki M'imunya; Faouzi Amokrane; Idi Nafiou; Jean-Jos? Wolomby; Kidza Mugerwa; Isilda Neves; Rosemary Nguti; Marius Kublickas; Matthews Mathai
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2009-09-27
Journal Detail:
Title:  International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics     Volume:  107     ISSN:  1879-3479     ISO Abbreviation:  Int J Gynaecol Obstet     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-11     Completed Date:  2010-02-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0210174     Medline TA:  Int J Gynaecol Obstet     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  191-7     Citation Subset:  IM    
Affiliation:
Department of Making Pregnancy Safer, World Health Organization, Geneva, Switzerland. shaha@who.int
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Africa / epidemiology
Breast Feeding / statistics & numerical data
Cesarean Section / mortality*,  statistics & numerical data*
Developing Countries
Female
Health Services Accessibility
Health Surveys
Humans
Infant Mortality
Infant, Newborn
Maternal Health Services / statistics & numerical data
Perinatal Care / statistics & numerical data
Pregnancy
Surgical Procedures, Elective / mortality*,  statistics & numerical data*
Treatment Outcome
World Health Organization
Young Adult

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