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Cesarean delivery outcomes from the WHO global survey on maternal and perinatal health in Africa
Author(s) -
Shah Archana,
Fawole Bukola,
M'Imunya James Machoki,
Amokrane Faouzi,
Nafiou Idi,
Wolomby JeanJosé,
Mugerwa Kidza,
Neves Isilda,
Nguti Rosemary,
Kublickas Marius,
Mathai Matthews
Publication year - 2009
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2009.08.013
Subject(s) - medicine , asphyxia , obstetrics , cesarean delivery , eclampsia , pregnancy , referral , maternal morbidity , genetics , family medicine , biology
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 83 439 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.