Perinatal outcomes of cesarean deliveries in Sierra Leone: A prospective multicenter observational study.
Cesarean delivery
Fetal monitoring
Partograph
Perinatal death
Perinatal mortality
Stillbirth
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
05
10
2019
revised:
08
01
2020
accepted:
15
04
2020
pubmed:
20
4
2020
medline:
5
11
2020
entrez:
20
4
2020
Statut:
ppublish
Résumé
To analyze the indications for cesarean deliveries and factors associated with adverse perinatal outcomes in Sierra Leone. Between October 2016 and May 2017, patients undergoing cesarean delivery performed by medical doctors and associate clinicians in nine hospitals were included in a prospective observational study. Data were collected perioperatively, at discharge, and during home visits after 30 days. In total, 1274 cesarean deliveries were included of which 1099 (86.3%) were performed as emergency surgery. Of the 1376 babies, 261 (19.0%) were perinatal deaths (53 antepartum stillbirths, 155 intrapartum stillbirths, and 53 early neonatal deaths). Indications with the highest perinatal mortality were uterine rupture (45 of 55 [81.8%]), abruptio placentae (61 of 85 [71.8%]), and antepartum hemorrhage (8 of 15 [53.3%]). In the group with cesarean deliveries performed for obstructed and prolonged labor, a partograph was filled out for 212 of 425 (49.9%). However, when completed, babies had 1.81-fold reduced odds for perinatal death (95% confidence interval 1.03-3.18, P-value 0.041). Cesarean deliveries in Sierra Leone are associated with an exceptionally high perinatal mortality rate of 190 per 1000 births. Late presentation in the facilities and lack of adequate fetal monitoring may be contributing factors.
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
213-221Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology
Informations de copyright
© 2020 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
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