Ali Y
Department of Obstetrics and Gynaecology, Jimma Institute of Health Sciences, Ethiopia.
East Afr Med J. 1995 Jan;72(1):60-3.
In this prospective study, 100 mothers who have undergone caesarean section in Jimma Hospital from 23rd June 1992 to 24th September 1993 were analysed to determine the incidence, indications and post operative complications of caesarean delivery. During the study period, there were 1236 deliveries, of whom 100 mothers were delivered by caesarean section; giving a caesarean birth rate of 8%. The leading indications for caesarean section were cephalopelvic disproportion (44%), malpresentations and malpositions (21%), repeat caesarean section (16%), antepartum haemorrhage (8%) and foetal distress (6%), accounting for 95% of the indications for caesarean section. There was no maternal death, but the overall morbidity rate was 20%. The causes of morbidity were wound infection (27.1%), sepsis (21.4%), endometritis (33.3%), haemorrhage (8%) and wound dehiscence (10%). The gross perinatal mortality rate of 120 per 1000 live births was not significantly higher than the rate for all deliveries, which was 92.5% per 1000 live births (P < 0.5). The single most important cause of perinatal death was prolonged and obstructed labour. In order to reduce the high perinatal mortality and maternal morbidity, there is a strong and urgent need to prevent prolonged and obstructed labour through effective antenatal care and referral system.
在这项前瞻性研究中，对1992年6月23日至1993年9月24日在吉马医院接受剖宫产的100名母亲进行了分析，以确定剖宫产的发生率、指征和术后并发症。在研究期间，共有1236例分娩，其中100名母亲通过剖宫产分娩；剖宫产率为8%。剖宫产的主要指征是头盆不称（44%）、胎位异常（21%）、再次剖宫产（16%）、产前出血（8%）和胎儿窘迫（6%），占剖宫产指征的95%。没有产妇死亡，但总体发病率为20%。发病原因包括伤口感染（27.1%）、败血症（21.4%）、子宫内膜炎（33.3%）、出血（8%）和伤口裂开（10%）。每1000例活产中120例的围产期总死亡率并不显著高于所有分娩的死亡率，后者为每1000例活产92.5%（P<0.5）。围产期死亡的唯一最重要原因是产程延长和产道梗阻。为了降低高围产期死亡率和产妇发病率，迫切需要通过有效的产前护理和转诊系统来预防产程延长和产道梗阻。
