TITLE:
Maternal and Perinatal Prognosis of the Cesarean at Chu Point G, Bamako, Mali
AUTHORS:
Coulibaly Ahmadou, Seydou Z. Dao, Cissouma Assétou, Sima Mamadou, Kanté Ibrahim Ousmane, Mamadou S. Traoré, Koné Konimba, Diarra Drissa, Sissoko Hamadi, Théra Thiounkani, Traore Youssouf
KEYWORDS:
Cesarean Section, Frequency, Maternal and Perinatal Prognosis
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.11,
November
11,
2021
ABSTRACT: Objective: In light of numerous obstetric evacuations to the Point G University
Hospital and taking into account the practice of cesarean section for many
years in the service, it seemed necessary to us to make our contribution to the
study of cesarean section by putting emphasis on maternal and perinatal
prognosis in the Obstetric Gynecology Department of the Point G university
hospital. Method and materials: We conducted a retrospective cross-sectional study in the Gynecology and
Obstetrics Department of the Point G University Hospital, from January 01, 2018
to December 31, 2018. The Point G University Hospital is a 3rd level center of
reference in the field of obstetrics in Mali. There is no neonatal ward. The
study included all women who gave birth in the gynecology and obstetrics
department during the study period. All prophylactic and emergency Caesarean
section records during the period in which management took place in the ward
were included. The records of patients who had a prophylactic or emergency
cesarean section in other health facilities and non-usable records were not
included. Data were collected using a pre-established survey form. The variables
analyzed were socio-epidemiological, clinical and prognostic. Data were
analyzed using IBM SPSS software version 16.00. The Chi2 test and Fischer’s
exact test were used to highlight risk factors. The significance level retained
was p 0.05. Operational definition: Nulliparous: A woman who has never given birth; Primipara:
A woman who gave birth once; Pauciparous: A woman who has a number of deliveries between two and three; Multiparous:
A woman who has a delivery count of between four and six pregnancies; Large
multipara: A woman who has given birth more than six times. Results: We recorded 608 deliveries by cesarean section out of a total of 1573
deliveries, i.e. a rate of 38.6%. The
majority of caesarized patients were between 20 and 29 years old or 41.94%, the
average age was 26 years old. Out-of-school patients were the most represented,
or 44.41%. They were pauciparous in 34.4% of cases. The pregnant majority had
performed at least 04 antenatal consultations, or 68.91%. In 74,
51% of the cases the patients carried a pregnancy estimated to term. Cesarean
section was performed urgently in 85.36% of cases and eclampsia crisis was the
most common maternal indication, or 27.97% among the 379 cases. We recorded 10
maternal deaths or 1.64%. The bleeding disorder was responsible for half of our
deaths, or 50%, from retro-placental hematoma. The fetal prognosis was
dominated by neonatal distress with 19.08% of cases. We recorded 101 cases of
stillbirths, or 16.61%, and 23 cases of early neonatal death, or 3.78%. Our
study found a statistically significant relationship between the type of
cesarean section and neonatal death with Fisher’s exact test = 27.772, P 0.0001.