Maternal Complications of Caesarean Section in a Resource-Limited Country: The Case of the Maternity Unit of Kankan Regional Hospital, Guinea

Abstract

Introduction: Innovations in surgical and anaesthetic techniques to provide a good maternal and child safety have made the cesarean section a routine intervention in obstetrics. However, its complications, especially the short or long term per and postoperative maternal ones, are not exceptional and can affect mothers’ vital prognosis. The objectives of this study were to describe the maternal per and postoperative complications encountered during the cesarean section. Patients and method: This is a prospective, descriptive and analytical study carried out at the maternity ward of Kankan Regional Hospital over a 6 month period from January 1, 2018 to June 30, 2018. Results: During this period, out of a total of 2229 deliveries, 319 caesarean sections were performed i.e. a rate of 12.51%. Complications concerned 111 patients (34.79%). The average age was 28 with extremes of 15 and 45. Non-medical transportation concerned 71.17% of our patients. The cesarean section was performed in emergency situations in 82.8% of cases. Indications were dominated by the fetopelvic disproportion. There was a statistically significant relationship between labour duration and the occurrence of complications. Intraoperative complications were dominated by bleeding (25.22% of all complications and 8.77% of total cesarean sections). Post-operative complications were dominated by parietal suppurations (94.49% of all complications and 34.79% of the total number of cesarean sections). In most cases, patients simultaneously developed several complications. Conclusion: The maternal complications of cesarean sections remain considerable. If the increase in the rate of caesarean sections has contributed to the improvement of the mother-fetal prognosis, the surgical procedure itself is not without complications, which encourages us to review its indications for a better management. Hemorrhagic and infectious complications were the most frequent. These results call for increased asepsis measures in our operation theaters to reduce infectious complications. The increase in Caesarean section rates over the years is faced with increased maternal morbidity in the short and long term. Its indications should be well thought out and should include the responsibility of an experienced obstetrician.