Cisse C T, Faye E O, de Bernis L, Dujardin B, Diadhiou F
Clinique gynécologique et obstétricale, CHU de Dakar, Université de Dakar, Dakar-Fann, Sénégal.
Sante. 1998 Sep-Oct;8(5):369-77.
A prospective longitudinal study was carried out of all women undergoing Cesarean section in the surgical maternity hospitals of Senegal between January 1 and December 31 1996. The epidemiology and quality of Cesarean sections were investigated. For each case, the following data were recorded: marital status, prenatal monitoring, conditions of hospitalization, indications for and outcome of surgery, maternal and neonatal follow-up one month after the operation. 2,436 Cesarean sections were performed. Of these, 2,269 cases were indexed and filed and 1,612 received a postnatal checkup one month after the operation. The mean age of the women involved was 26 years. The referral system is not effective, with 58% of patients being rushed to a surgical maternity unit in medically unsuitable forms of transport. Cesarean section is not widely available either geographically or economically. The mean national rate of Cesarean section was 0.6% of expected births but there were differences between regions. The main indications for Cesarean section were the fetus being too large to pass through the pelvic girdle (30%) and fetal suffering (18%). The maternal mortality rate was 3% and one third of the women who died did so immediately after the operation. Maternal morbidity occurred in 10% of cases, mainly due to postoperative infection. The rate of perinatal stress was 25%, most deaths being caused by neonatal distress (33%) or infection (18%). Thus, overall, both the availability and quality of Cesarean section in Senegal are poor.
1996年1月1日至12月31日期间，在塞内加尔外科产科医院对所有接受剖宫产的妇女进行了一项前瞻性纵向研究。调查了剖宫产的流行病学和质量。对于每一个病例，记录了以下数据：婚姻状况、产前监测、住院条件、手术指征和结果、术后1个月的母婴随访情况。共进行了2436例剖宫产。其中，2269例进行了索引和归档，1612例在术后1个月接受了产后检查。参与研究的妇女平均年龄为26岁。转诊系统效率低下，58%的患者乘坐医疗上不合适的交通工具匆忙前往外科产科病房。剖宫产在地理和经济上都不普及。全国剖宫产平均率为预期分娩数的0.6%，但各地区存在差异。剖宫产的主要指征是胎儿过大无法通过骨盆（30%）和胎儿窘迫（18%）。孕产妇死亡率为3%，三分之一的妇女在手术后立即死亡。10%的病例发生了孕产妇发病，主要原因是术后感染。围产期应激率为25%，大多数死亡是由新生儿窘迫（33%）或感染（18%）引起的。因此，总体而言，塞内加尔剖宫产的可及性和质量都很差。
