Schantz Clémence, Ravit Marion, Traoré Abou Bakary, Aboubakar Moufalilou, Goyet Sophie, de Loenzien Myriam, Dumont Alexandre
Ceped, IRD, Université Paris Descartes, Inserm, Paris, France.
Ceped, IRD, Université Paris Descartes, Inserm, Paris, France.
Sex Reprod Healthc. 2018 Jun;16:10-14. doi: 10.1016/j.srhc.2018.01.001. Epub 2018 Jan 10.
To assess new estimates of caesarean section (c-section) rates in facilities in two sub-Saharan countries using the Robson classification.
This study is a retrospective study. Workshops were organized in Mali and Benin in 2017 to train health care professionals in the use of the Robson classification. Nine health facilities in Mali and Benin were selected to participate in the study. Data for deliveries performed in 2014, 2015, and 2016 were included.
A total of 12,472 deliveries were included. The overall c-section rate was high in facilities in both countries: 31.0% in Mali and 43.9% in Benin. Women classified as high-risk (groups 6-10) were small relative contributors to the overall c-section rate (19.3% in Mali and 25.3% in Benin), while low-risk women (groups 1-4) were high relative contributors (55.4% in Mali and 45.2% in Benin). C-section rates in women who had undergone a previous c-section were especially high in both countries (84.0% in Mali; 82.5% in Benin). This group was the largest contributor to the overall c-section rates in both countries.
We found high c-section rates in facilities in Mali and Benin, particularly for low-risk women and for women with a previous c-section. Further investigations should be carried out to understand why the c-section rates are so high in these facilities. Strategies must be implemented to avoid unnecessary c-sections, which potentially lead to further complications, particularly in countries with high fertility rates.
使用罗布森分类法评估撒哈拉以南两个国家医疗机构的剖宫产率新估计值。
本研究为回顾性研究。2017年在马里和贝宁举办了研讨会，培训医护人员使用罗布森分类法。选取了马里和贝宁的9家医疗机构参与研究。纳入了2014年、2015年和2016年分娩的数据。
共纳入12472例分娩。两国医疗机构的总体剖宫产率都很高：马里为31.0%，贝宁为43.9%。被归类为高危（第6 - 10组）的女性对总体剖宫产率的贡献相对较小（马里为19.3%，贝宁为25.3%），而低危女性（第1 - 4组）的贡献相对较大（马里为55.4%，贝宁为45.2%）。两国中曾接受过剖宫产的女性的剖宫产率尤其高（马里为84.0%；贝宁为82.5%）。该组是两国总体剖宫产率的最大贡献者。
我们发现马里和贝宁医疗机构的剖宫产率很高，尤其是低危女性和曾接受过剖宫产的女性。应进一步开展调查，以了解这些医疗机构剖宫产率如此之高的原因。必须实施策略以避免不必要的剖宫产，因为这可能会导致更多并发症，尤其是在生育率高的国家。
