The Free Cesarian in the Health District of Bougouni

Cheickna Sylla,Soumana Oumar Traoré,Seydou Fané,Ibrahima Tegueté,Sitapha Dembele,Niani Mounkoro,Amadou Boucoum,Youssouf Traoré,Seydou Z Dao,Lassana Togola

doi:10.4236/ojog.2020.1090115

Abstract

Purpose: The purpose of this study was to assess the impact of free caesarean section on maternal-fetal prognosis. Materials and Methods: This was a descriptive, cross-sectional, comparative analytical study of one year of non-free caesarean section and three years of free with retrospective data collection. Our study took place from January 1, 2004 to December 31, 2004 and from January 1, 2007 to December 31, 2009. Results: Caesarean section completion rates are 1.28%, 1.30%, 1.53%, 1.32% respectively in 2004, 2007, 2008, 2009. The average age was 27 years with extremes of 15 to 40 years. The peak of evacuations was recorded in 2007 with a rate of 89.4% and the peak of direct admissions in 2009 with a rate of 14.9%. An adequate means of transport was used in 77.20%. In 22.80% of cases an inadequate means was used. The indications of caesarean sections were dominated by preeclampsia 211/1045 caesarean section followed by acute fetal suffering 179/1045; 86/1045; placenta previa 64/1045; presentations of the shoulder i.e. 53/1045; pre-rupture syndrome 44/1045; retro-placental hematoma 27/1045. In terms of maternal prognosis: we noted maternal deaths with a rate of 2.4%, 2.4%, 4.3%, 0.4% respectively in 2004, 2007, 2008, 2009. And stillbirth rates were 17.6%, 22.4%, 27.4%, 21.7% respectively in 2004, 2007, 2008, 2009. The average length of hospitalization was 10 days. Conclusion: Free caesarean section would be a factor in improving the maternal-fetal prognosis.

Highlights

Caesarean section is defined as an obstetrical technique consisting of surgical incision of the abdominal wall and uterus for rapid evacuation of the conceived product [1]
The purpose of this study was to assess the impact of free caesarean section on maternal-fetal prognosis
Free caesarean section would be a factor in improving the maternal-fetal prognosis

Summary

Introduction

Caesarean section is defined as an obstetrical technique consisting of surgical incision of the abdominal wall and uterus for rapid evacuation of the conceived product [1]. With an estimated maternal mortality rate of 1020 deaths per 100,000 live births (WHO, 1990) [2], West Africa is the region most affected. This increase is due to low coverage of maternal health needs. In Mali, the direct estimate of the maternal mortality rate in 2006 was 464 deaths per 100,000 live births according to EDSM IV, despite efforts to reduce maternal mortality. Considered from the 19th to the 20th century as a perilous, deadly undertaking in the living woman [3], the practice of caesarean section would be a factor in improving obstetric care. Its indications are increasingly spread over several obstetric pathologies resulting in an increase in its frequency over the last two decades

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Conclusion