Bouillin D, Fournier G, Gueye A, Diadhiou F, Cissé C T
Coopération française Région médicale, Kaolack, Sénégal.
Sante. 1994 Nov-Dec;4(6):399-406.
Maternal morbidity and mortality remain major problems of public health in developing countries. Having long been neglected, maternal health is now being included among the priorities of a large number of countries. The rate of maternal mortality in Senegal is 850 per 100,000 live births, among the highest in the world. The main causes of maternal mortality in Africa are obstructed labour and uterine rupture, hypertensive disorders of pregnancy, puerperal infection and haemorrhage. An epidemiological survey of obstetric disorders was initiated in 1992 in Senegal to characterise the requirements for surgical coverage during pregnancy and delivery. In 1992, the national rate of caesarean section was low (0.66% of estimated births). However, rates differed greatly between regions, and between rural and urban areas. The indications for caesarean section were classified into three groups, each corresponding to a different public health issue. The rate of maternal mortality associated with surgery was high: 4.7%, of which 29% during surgery and 71% post op. Perinatal prognosis was also poor, with a mortality rate of approximately 30%. There are only 18 reference obstetrics units functioning, and they give a very uneven coverage of the country. These finding have led to new guidelines to improve the quality and cover of maternal care over the coming years.
孕产妇发病和死亡仍是发展中国家公共卫生的主要问题。长期以来被忽视的孕产妇健康，如今已被纳入许多国家的优先事项之中。塞内加尔的孕产妇死亡率为每10万例活产850例，是世界上最高的之一。非洲孕产妇死亡的主要原因是产程梗阻和子宫破裂、妊娠期高血压疾病、产褥期感染和出血。1992年在塞内加尔启动了一项产科疾病流行病学调查，以确定孕期和分娩期间手术覆盖的需求。1992年，全国剖宫产率很低（估计出生数的0.66%）。然而，不同地区以及城乡之间的剖宫产率差异很大。剖宫产指征分为三组，每组对应一个不同的公共卫生问题。与手术相关的孕产妇死亡率很高：4.7%，其中29%发生在手术期间，71%发生在术后。围产期预后也很差，死亡率约为30%。仅有18个参考产科单位在运作，它们对该国的覆盖很不均衡。这些发现促成了新的指导方针，以在未来几年提高孕产妇护理的质量和覆盖面。
