Perinatal outcomes of cesarean deliveries in Sierra Leone: A prospective multicenter observational study

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Abstract

Objective: To analyze the indications for cesarean deliveries and factors associated with adverse perinatal outcomes in Sierra Leone. Methods: 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. Results: 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). Conclusion: 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.

Detaljer

Författare
  • Alex J. van Duinen
  • Josien Westendorp
  • Michael M. Kamara
  • Fatu Forna
  • Lars Hagander
  • Marcus J. Rijken
  • Andrew J.M. Leather
  • Arne Wibe
  • Håkon A. Bolkan
Enheter & grupper
Externa organisationer
  • Norwegian University of Science and Technology
  • St. Olav’s University Hospital
  • University Medical Center Utrecht
  • Ministry of Health and Sanitation, Sierra Leone
  • Skåne University Hospital
  • University of Sierra Leone
  • World Health Organization, Sierra Leone
  • King's College London
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Reproduktionsmedicin och gynekologi

Nyckelord

Originalspråkengelska
TidskriftInternational Journal of Gynecology and Obstetrics
StatusE-pub ahead of print - 2020 apr 19
PublikationskategoriForskning
Peer review utfördJa