Roudière J L
Service de gynécologie-obstétrique, Centre hospitalier Saint-Louis, L'Aigle.
Sante. 1998 Sep-Oct;8(5):325-9.
In 1993, 2,008 deliveries were recorded at the Provincial Maternity Hospital at Franceville in Gabon. The frequency of cesarean section was 3%. The perinatal mortality of children born by cesaraean section was high, 213 per thousand. The principal indications for cesarean section were the baby being too large to pass through the pelvis, bicicatricial uterus, breech presentation and toxemia during pregnancy. The maternal mortality rate was 200 per 100,000, similar to the rates of most African countries, and 75% of the women that died had undergone cesarean section. The mortality rate for cesarean section was high (4.9%), so the indications for cesarean section in underdeveloped countries are limited. Malaria was the principal reason for the hospitalization of pregnant women, because it is endemic and is a serious condition for pregnant women. The next most frequent causes of hospitalization were a high risk of premature labor and hyperemesis gravidarum, the frequency of which is high among pregnant African women, particularly those of West Africa. Toxemia in pregnancy was the fourth most important cause of hospitalization. The rate of cesarean section rupture was 2.5 per thousand. Only 20% of these cases involved a cicatricial uterus, with no maternal deaths but a fetal mortality rate of 100%. The frequency of premature birth was 4.23% and the perinatal mortality rate was 48 per thousand, with 37 stillbirths per thousand and an early neonatal mortality rate of 11 per thousand. The perinatal mortality of breech presentations was high (330 per thousand), with 13.9 delivered by cesarean section. These levels are similar to those for other African countries. Maternal health could be improved by introducing several consultations during pregnancy, improving hospital hygiene and making antibiotics more widely available. Fetal survival could be improved by preventing premature births, providing more help with delivery, decreasing the time to intervention and improving neonatal resuscitation techniques.
1993年，加蓬弗朗斯维尔省妇产医院记录了2008例分娩。剖宫产率为3%。剖宫产出生儿童的围产期死亡率很高，每千例中有213例。剖宫产的主要指征是胎儿过大无法通过骨盆、双子宫、臀位和孕期毒血症。孕产妇死亡率为每10万例中有200例，与大多数非洲国家的死亡率相似，死亡的妇女中有75%接受了剖宫产。剖宫产死亡率很高（4.9%），因此在欠发达国家剖宫产的指征是有限的。疟疾是孕妇住院的主要原因，因为疟疾是地方病，对孕妇来说是一种严重疾病。其次最常见的住院原因是早产高危和妊娠剧吐，非洲孕妇中，尤其是西非孕妇，其发生率很高。孕期毒血症是第四重要的住院原因。剖宫产子宫破裂率为每千例中有2.5例。这些病例中只有20%涉及瘢痕子宫，没有孕产妇死亡，但胎儿死亡率为100%。早产发生率为4.23%，围产期死亡率为每千例中有48例，其中死产率为每千例中有37例，早期新生儿死亡率为每千例中有11例。臀位的围产期死亡率很高（每千例中有330例），其中13.9%通过剖宫产分娩。这些水平与其他非洲国家的水平相似。通过在孕期进行多次会诊、改善医院卫生条件和更广泛地提供抗生素，可以改善孕产妇健康。通过预防早产、在分娩时提供更多帮助、减少干预时间和改进新生儿复苏技术，可以提高胎儿存活率。
