Tadesse E, Adane M, Abiyou M
East Afr Med J. 1996 Sep;73(9):619-22.
This prospective hospital-based study was done at Tikur Anbessa Teaching Hospital (TATH) between July 1991 and July 1992 in order to obtain base-line data on the rates of caesarean section, pregnancy out-come, major indications for caesarean and caesarean section complications. Out of a total of 3237 deliveries conducted during the study period, 318(10%) were caesarean section. The leading or the major indication for abdominal deliveries were: repeat caesarean section, 103(32.4%), cephalo-pelvic disproportion, 93(29.2%), placenta previa and abruptio-placentae 40(12.6%). Age ranged from 15-40 years, 58(18.2%) were women under the age of 20, and 182(57%) were between 20 and 30 years of age which is the safest period to bear children. Eighty one (25%) of the mothers were primiparae, 158(50%) were between para one and para four, 79(25%) were grand multiparae. Seventy six (24%) of the cases were not registered for antenatal care in any health institutions. Two hundred and fifteen (67.6%) of the mothers had primary caesarean section. The chance of repeat caesarean section was statistically significant (P < 0.001). Fifty seven (18%) had elective caesarean section and 261 (82%) were emergency caesarean section. On eight (2.5%) of the patient, obstetric hysterectomy was performed. There were five maternal deaths among the caesarean section cases. The main cause of maternal death was failure to control bleeding during the caesarean section. These were preventable deaths in experienced hands. There were nine (2.8%) stillbirths and 15(4.7%) early neonatal deaths. A foetal wastage of 24(7.5%) was noted in the study. The mean birthweight among booked caesarean section were 3108 grams and unbooked caesarean section were 2991 grams. The major obstetric complications in the cases were antepartum haemorrhage, and 34(11%), pregnancy induced-hypertensive disorder, 32(10%). Sixty one (19%) had blood transfusion. The blood loss was significantly more in operations done by residents compared to consultants even using the most crude measurement as estimated by the operator at the time.
这项前瞻性的基于医院的研究于1991年7月至1992年7月在提库尔·安贝萨教学医院（TATH）进行，目的是获取剖宫产率、妊娠结局、剖宫产主要指征及剖宫产并发症的基线数据。在研究期间进行的3237例分娩中，有318例（10%）为剖宫产。腹部分娩的主要或首要指征为：再次剖宫产103例（32.4%）、头盆不称93例（29.2%）、前置胎盘和胎盘早剥40例（12.6%）。年龄范围为15至40岁，58例（18.2%）为20岁以下女性，182例（57%）年龄在20至30岁之间，这是生育最安全的时期。81例（25%）母亲为初产妇，158例（50%）为经产妇1至4次，79例（25%）为多产妇。76例（24%）病例未在任何医疗机构登记产前检查。215例（67.6%）母亲进行了初次剖宫产。再次剖宫产的几率具有统计学意义（P < 0.001）。57例（18%）进行了择期剖宫产，261例（82%）为急诊剖宫产。8例（2.5%）患者进行了产科子宫切除术。剖宫产病例中有5例产妇死亡。产妇死亡的主要原因是剖宫产术中出血控制不佳。在经验丰富的医生手中，这些死亡是可以预防的。有9例（2.8%）死产和15例（4.7%）早期新生儿死亡。研究中发现胎儿丢失24例（7.5%）。预约剖宫产的平均出生体重为3108克，未预约剖宫产的平均出生体重为2991克。这些病例中的主要产科并发症为产前出血34例（11%）、妊娠高血压疾病32例（10%）。61例（19%）接受了输血。即使采用术者当时估计的最粗略测量方法，住院医生进行的手术中的失血量也明显多于顾问医生进行的手术。
