title: [Cesarean sections in Senegal: coverage of needs and quality of services].
abstract: A prospective longitudinal study was carried out of all women undergoing Cesarean section in the surgical maternity hospitals of Senegal between January 1 and December 31 1996. The epidemiology and quality of Cesarean sections were investigated. For each case, the following data were recorded: marital status, prenatal monitoring, conditions of hospitalization, indications for and outcome of surgery, maternal and neonatal follow-up one month after the operation. 2,436 Cesarean sections were performed. Of these, 2,269 cases were indexed and filed and 1,612 received a postnatal checkup one month after the operation. The mean age of the women involved was 26 years. The referral system is not effective, with 58% of patients being rushed to a surgical maternity unit in medically unsuitable forms of transport. Cesarean section is not widely available either geographically or economically. The mean national rate of Cesarean section was 0.6% of expected births but there were differences between regions. The main indications for Cesarean section were the fetus being too large to pass through the pelvic girdle (30%) and fetal suffering (18%). The maternal mortality rate was 3% and one third of the women who died did so immediately after the operation. Maternal morbidity occurred in 10% of cases, mainly due to postoperative infection. The rate of perinatal stress was 25%, most deaths being caused by neonatal distress (33%) or infection (18%). Thus, overall, both the availability and quality of Cesarean section in Senegal are poor.
authors.affiliation: Clinique gynécologique et obstétricale, CHU de Dakar, Université de Dakar, Dakar-Fann, Sénégal.
authors.forename: C T
authors.initials: CT
authors.lastname: Cisse
authors.forename: E O
authors.initials: EO
authors.lastname: Faye
authors.forename: L
authors.initials: L
authors.lastname: de Bernis
authors.forename: B
authors.initials: B
authors.lastname: Dujardin
authors.forename: F
authors.initials: F
authors.lastname: Diadhiou
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000401:mortality / Q000592:standards* / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006302:Health Services Research; D006771:Hospitals, Maternity; D006801:Humans; D008428:Maternal Mortality; D009017:Morbidity; D011379:Prognosis; D011446:Prospective Studies; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000592:standards; D012675:Senegal
vernacular_title: Césariennes au Sénégal: couverture des besoins et qualité des services.