TITLE:
The Caesarean Section in Dakar: Indications and Analysis Prognosis
AUTHORS:
Moussa Diallo, Marie Edward Faye Dieme, Omar Gassama, Astou Coly Niassy Diallo, Mame Diarra Ndiaye Gueye, Jean Charles Moreau
KEYWORDS:
Cesarean Section, Indication, Misgav Ladach, Maternal and Fetal Prognosis
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.9,
September
6,
2019
ABSTRACT: The
objective of this study was to analyze the indications of cesarean sections
performed in a Level II clinic and to evaluate early maternal and neonatal
outcome in the context of decentralization of obstetric and emergency newborn
care. Material and Method: This was a retrospective descriptive and
analytical study conducted at the maternity CSNC over a period of 12 months
from 1 July 2010 to 30 June 2011. It included all women in childbirth by caesarean section and excluded patients admitted for management of complications of cesarean section
performed in another structure. Results: During the study period, 595
caesarean sections were performed on a total of 4410 births, a rate of 13.5%.
The average age of patients was 27 years. The mean parity was 2. The patients
came from them even 55%. They were admitted with a single uterine scar in
28.40% of cases and bi-scar in 25.4% of cases. A pathology was associated with
pregnancy in 31.6% of cases. These pathologies were dominated by vascular and
renal syndromes (75.5%), anemia (13.8%) and the obstacles previa (10.1%).
Caesarean sections were performed in 517 patients in emergency. The technique
of Misgav Ladach was the most common 75.1%. The average hospital stay was 4.2
days with extremes of 0 and 15 days. Postoperative maternal mortality was
0.34%. Operative follow-up was simple in 98.3% of patients. Two patients
(0.34%) died after surgery. In 92.4% of the cases, the newborns were alive. The
Apgar score in the first minute was favorable (greater than or equal to 7/10)
in 503 newborns (95.1%) and unfavorable (less than 7/10) in 47 cases (8.55%).
At the fifth minute, he was favorable in 98.5% of the cases. Overall stillbirth
was 72.26‰ with a total of 43 stillbirths including 3 macerated stillbirths. Conclusion: Cesarean section is by far the most accomplished action in gynecology and
obstetrics. Its ease of implementation and low cost, and of course his results
in terms of reduction of maternal-fetal morbidity and mortality make a key
intervention and allowed its extension.