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.
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: Oluwarotimi I Akinola; Adetokunbo O Fabamwo; Adetokunbo O Tayo; Kabiru A Rabiu; Yussuf A Oshodi; Chioma A Onyekwere Journal: BMC Pregnancy Childbirth Date: 2010-09-23 Impact factor: 3.007
Authors: Sarah Saleem; Elizabeth M McClure; Shivaprasad S Goudar; Archana Patel; Fabian Esamai; Ana Garces; Elwyn Chomba; Fernando Althabe; Janet Moore; Bhalachandra Kodkany; Omrana Pasha; Jose Belizan; Albert Mayansyan; Richard J Derman; Patricia L Hibberd; Edward A Liechty; Nancy F Krebs; K Michael Hambidge; Pierre Buekens; Waldemar A Carlo; Linda L Wright; Marion Koso-Thomas; Alan H Jobe; Robert L Goldenberg Journal: Bull World Health Organ Date: 2014-06-05 Impact factor: 9.408
Authors: Margo S Harrison; Ephrem Kirub; Tewodros Liyew; Biruk Teshome; Andrea Jimenez-Zambrano; Margaret Muldrow; Teklemariam Yarinbab Journal: J Womens Health Dev Date: 2021-04-14