[Epidemiology and prognosis of caesarean sections in University Hospital of Dakar].
Caesarean section is our first activity in obstetrical surgery. Due to his high frequency and the maternal and foetal prognostic, we have undertaken to do a prospective, longitudinal, exhaustive study concerning all women whose delivery necessitated a caesarean section, between 01 January and 31 December 2001 in Gynaecological and Obstetrical Clinic of University Hospital Center Le Dantec. Our objectives were: describe the epidemiological aspects, evaluate the maternal and foetal prognosis of caesarean sections performed in University Hospital Center. The study revealed that 25.1% of births necessitated a caesarean section. The average age was of 26; the mean parity of 2; the medium height of 161cm. 26.4% of patients were evacuated and coming from the health centers in majority (41.9%) with unmedicalised evacuation in 44.9% of cases. 78.7% of patients have realised at least 3 antenatal consultations. The mains indications were cephalopelvic disproportions (34.9%) and foetal distress (18.9%). The classification per indications group revealed that 37.2% were "prudence caesarean section", 40.1% were "obligator's caesarean section" and 22.7% "necessity's caesarean section". The mean Apgar's score at the birth was 6,5 at first minute. 12 maternal deaths were noted, means 0.8% of global lethality; the morbidity was at 10.5% of cases, represented mainly by postoperative infection (64.3%). The per natal mortality was estimated to 5.9% and neonatal morbidity to 32%. About the quality of caesarean sections, the temporal (24h/24) and financial(kit of caesarean section) accessibilities are more satisfying; otherwise the quality of surgical act and the postoperative follow-up was not optimal. An inflationist advancement is actually noted about the rate of caesarean section, and due to the widening of the indications to the foetal interest. Nevertheless, despite agreed efforts, the quality is still insufficient because the maternal and per natal morbidity and mortality are still high.
Ngom
P M
PM
Clinique Gynécologique et Obstétrical, CHU Aristide Le Dantec.
Cisse
C T
CT
Cisse
M L
ML
Faye
E O
EO
Moreau
J C
JC
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data*; D016021:Epidemiologic Studies; D005260:Female; D017048:Health Care Costs; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D008428:Maternal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D011787:Quality of Health Care; D012189:Retrospective Studies; D012675:Senegal