Oladapo Olufemi T, Lamina Mustafa A, Sule-Odu Adewale O
Department of Obstetrics and Gynaecology, Obafemi Awolowo College of Health Sciences/Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.
Aust N Z J Obstet Gynaecol. 2007 Apr;47(2):110-4. doi: 10.1111/j.1479-828X.2007.00695.x.
Data about maternal outcomes of elective Caesarean section in low-income countries are limited.
To estimate the maternal morbidity and mortality associated with elective Caesarean delivery at a Nigerian University hospital.
Retrospective analysis of all elective Caesarean deliveries at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria (1990-2005). For each case of elective Caesarean delivery, four parturients who achieved non-operative vaginal delivery following spontaneous onset of labour were selected to serve as a referent group. Morbidity outcomes and mortality among women who had elective Caesarean delivery were compared with those of the referent group to estimate their comparative risks. Level of significance was put at P<0.05.
A total of 164 elective Caesarean sections were performed out of 6882 deliveries (2.4%). All morbidities were more frequent among women who had elective Caesarean section compared to those who had vaginal delivery but only peripartum blood transfusion (11.6 vs 5.6%), puerperal febrile morbidity (11.0 vs 4.7%), unplanned readmission (4.3 vs 1.4%), mean fall in haemoglobin concentration (1.5 +/- 0.6 vs 0.5 +/- 0.7 g/dL) and mean hospital stay (13.3 +/- 8.8 vs 6.2 +/- 5.4 days) showed statistically significant differences. There was one maternal death among the elective Caesarean section group, giving a maternal mortality ratio of 6.1:1000 deliveries, which was not significantly different from 3.0:1000 deliveries in the referent group.
Elective Caesarean delivery in this hospital is certainly accompanied by considerable maternal risks and should be offered to pregnant women with extreme caution. Efforts should be made to improve its safety by investigating and rectifying the factors responsible for the associated severe maternal complications.
低收入国家择期剖宫产的孕产妇结局数据有限。
评估尼日利亚一家大学医院择期剖宫产相关的孕产妇发病率和死亡率。
对尼日利亚萨加穆市奥拉比斯·奥纳班乔大学教学医院1990年至2005年期间所有择期剖宫产进行回顾性分析。对于每例择期剖宫产病例，选取4例自然发动分娩后经阴道非手术分娩的产妇作为参照组。将择期剖宫产产妇的发病结局和死亡率与参照组进行比较，以评估其相对风险。显著性水平设定为P<0.05。
6882例分娩中共有164例进行了择期剖宫产（2.4%）。与经阴道分娩的产妇相比，择期剖宫产产妇的所有发病情况更为常见，但只有围产期输血（11.6%对5.6%）、产褥期发热性疾病（11.0%对4.7%）、计划外再次入院（4.3%对1.4%）、血红蛋白浓度平均下降（1.5±0.6对0.5±0.7 g/dL）和平均住院时间（13.3±8.8对6.2±5.4天）显示出统计学显著差异。择期剖宫产组有1例孕产妇死亡，孕产妇死亡率为6.1:1000例分娩，与参照组的3.0:1000例分娩无显著差异。
该医院的择期剖宫产确实伴有相当大的孕产妇风险，应极其谨慎地为孕妇提供。应努力通过调查和纠正导致相关严重孕产妇并发症的因素来提高其安全性。
