Introduction: Cesarean permits to treat difficulties related to vaginal delivery and risk situations of fetal asphyxia. It also permits to save the mother and fetus. However, in developing countries as ours, complications related to this cesarean are not to be neglected. It constitutes an important cause of maternal and fetal morbidity and mortality. Here, the experience of the structure of complications of cesarean is reported.
Objectives: The objectives of this study were to study the
complications of cesarean section at the teaching hospital Gabriel TOURE,
Bamako, Mali.
Materials and Methods: A cross-sectional analytic study from
January 1st 2003 to December 31st 2013 was carried out. All the patients who
gave birth by cesarean operation in the gynecology-obstetric service of the
teaching hospital Gabriel TOURE were included during this period of study.
Descriptive statistics were used, Chi-square test, Pearson, and Cochran
Armitage test have been used to calculate the P-value of trend. A multivariate analyses
with a high alpha threshold of 10%, and then logistic regression multivariate
was performed. It has been applied to appreciate the effect of maternal
characteristics, obstetric practice, systemic factors, on the cesarean delivery
rate and the complications.
Results: We have registered 28,376 deliveries with 9509
cases of cesarean (33.5%) and a complication cesarean rate of 32% (3049/9509).
The main risk factors for cesarean operation completions were adolescence,
primiparity, obesity, the non-realization of antenatal care, evacuations and
co-morbidities. Intraoperative complications were dominated by hemorrhage 8.3%
and bladder lesion 1.1%, whereas anemia (58.8%) and parietal infection (21.1%)
dominated the postoperative complications table. The evacuation (Odds Ratio
adjusted (ORa) = 1.96) as well as pre-eclampsia/eclampsia (ORa = 2.34) and the
sickle cell disease (ORa = 9.99) were the main influencing factors of maternal
death. Praevia placenta (ORa = 1.75) abruption placenta (ORa = 11.08) and fetal
malformation (ORa = 2.21) dominated the influencing factors of perinatal death.
Conclusion: The cesarean complications rates were high in our improvement of
the quality of antenatal care. The reorganization and revitalization of the
reference and against reference system will permit the program some cesarean
operations to reduce the morbidity related to cesarean.
Author (s) Details
Abdoulaye Sissoko
Teaching Hospital Gabriel TOURE, Bamako, Mali.
Alassane Traore
Teaching Hospital, Bamako, Mali.
Ibrahim Kante
Teaching Hospital Point G, Bamako, Mali.
Amadou Bocoum
Teaching Hospital Gabriel TOURE, Bamako, Mali.
Soumana Oumar Traore
District Hospital Commune V, Bamako, Mali.
Seydou Fane
Teaching Hospital Gabriel TOURE, Bamako, Mali.
Daniel Dembele
Teaching Hospital Gabriel TOURE, Bamako, Mali.
Aminata Kouma
Teaching Hospital Kati, Bamako, Mali.
Mamadou Sima
Teaching Hospital Point G, Bamako, Mali.
Fatoumata K. Tounkara
Research Center CHU of Quebec, University of Laval, Quebec, Canada.
Amadou Fomba
Teaching Hospital Gabriel TOURE, Bamako, Mali.
Ibrahima Teguete
Teaching Hospital Gabriel TOURE, Bamako, Mali.
Youssouf Traore
Teaching Hospital Gabriel TOURE, Bamako, Mali.
Soumaila Keita
Teaching Hospital Point G, Bamako, Mali.
Niani Moukoro
Teaching Hospital Gabriel TOURE, Bamako, Mali.
Please see the book here:- https://doi.org/10.9734/bpi/msti/v9/4224
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