Ameh E A, Mbibu H N, Adams L M, Nmadu P T
Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
East Afr Med J. 1998 Jan;75(1):27-9.
In a rural hospital in northern Nigeria, general surgeons performed 217 obstetric and gynaecologic operations over a five-year period. These operations were responsible for 23% of all operations at the hospital. Emergency operations were most frequent with caesarean section accounting for 90%. Eighty five per cent of the caesarean sections were performed for cephalopelvic dysproportion. The complications encountered were mostly septic complications, predominantly in patients who had caesarean section for obstructed labour. The overall mortality was 5.1% and neonatal mortality from caesarean section was 4.8%. It is concluded that in the abscence of an obstetrician and gynaecologist general surgery experience is required to manage obstetric and gynaecologic problems in rural areas. Such experience should be considered when recruiting doctors for rural hospitals in developing countries.
在尼日利亚北部的一家乡村医院，普通外科医生在五年时间里实施了217例妇产科手术。这些手术占该医院所有手术的23%。急诊手术最为常见，其中剖宫产占90%。85%的剖宫产手术是因头盆不称进行的。所遇到的并发症大多是感染性并发症，主要发生在因产程梗阻而行剖宫产的患者中。总体死亡率为5.1%，剖宫产术后新生儿死亡率为4.8%。得出的结论是，在没有妇产科医生的情况下，农村地区处理妇产科问题需要普通外科经验。在为发展中国家的乡村医院招聘医生时应考虑到这种经验。
