Perinatal outcomes of cesarean deliveries in Sierra Leone : A prospective multicenter observational study
van Duinen, Alex J. LU ; Westendorp, Josien ; Kamara, Michael M. ; Forna, Fatu ; Hagander, Lars LU
; Rijken, Marcus J.
; Leather, Andrew J.M.
; Wibe, Arne
and Bolkan, Håkon A.
(2020)
In International Journal of Gynecology and Obstetrics
150(2).
p.213-221
- 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... (More)
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.
(Less)
- author
- van Duinen, Alex J.
LU
; Westendorp, Josien
; Kamara, Michael M.
; Forna, Fatu
; Hagander, Lars
LU
; Rijken, Marcus J.
; Leather, Andrew J.M.
; Wibe, Arne
and Bolkan, Håkon A.
- organization
- publishing date
- 2020-08
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cesarean delivery, Fetal monitoring, Partograph, Perinatal death, Perinatal mortality, Stillbirth
- in
- International Journal of Gynecology and Obstetrics
- volume
- 150
- issue
- 2
- pages
- 9 pages
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85085499277
- pmid:32306384
- ISSN
- 0020-7292
- DOI
- 10.1002/ijgo.13172
- language
- English
- LU publication?
- yes
- id
- a5dad309-7b2f-41d1-9c19-37abdb7e1672
- date added to LUP
- 2020-06-16 14:36:32
- date last changed
- 2024-05-15 12:52:58
@article{a5dad309-7b2f-41d1-9c19-37abdb7e1672,
abstract = {{<p>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.</p>}},
author = {{van Duinen, Alex J. and Westendorp, Josien and Kamara, Michael M. and Forna, Fatu and Hagander, Lars and Rijken, Marcus J. and Leather, Andrew J.M. and Wibe, Arne and Bolkan, Håkon A.}},
issn = {{0020-7292}},
keywords = {{Cesarean delivery; Fetal monitoring; Partograph; Perinatal death; Perinatal mortality; Stillbirth}},
language = {{eng}},
number = {{2}},
pages = {{213--221}},
publisher = {{Wiley-Blackwell}},
series = {{International Journal of Gynecology and Obstetrics}},
title = {{Perinatal outcomes of cesarean deliveries in Sierra Leone : A prospective multicenter observational study}},
url = {{http://dx.doi.org/10.1002/ijgo.13172}},
doi = {{10.1002/ijgo.13172}},
volume = {{150}},
year = {{2020}},
}