Outcomes and quality of care for women and their babies after caesarean section in Nigeria.

Autor: Adeniran AS; Department of Obstetrics & Gynaecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria., Nwachukwu DC; Department of Obstetrics & Gynaecology, Federal Medical Centre, Bida, Nigeria., Ocheke AN; Department of Obstetrics & Gynaecology, Jos University Teaching Hospital, Jos, Nigeria., Mohammed SO; Department of Obstetrics & Gynaecology, Dalhatu Araf Specialist Hospital, Lafia, Nigeria., Musa AO; Department of Obstetrics & Gynaecology, Federal Medical Centre, Lokoja, Nigeria., Ochejele S; Department of Obstetrics & Gynaecology, Federal Medical Centre, Makurdi, Nigeria., Ibraheem RS; Department of Obstetrics & Gynaecology, IVF Centre, National Hospital, Abuja, Nigeria., Pam S; Department of Obstetrics & Gynaecology, Federal Medical Centre, Keffi, Nigeria., Mairami AB; Department of Paediatrics, National Hospital, Abuja, Nigeria., Gobir AA; Department of Paediatrics, University of Ilorin Teaching Hospital, Ilorin, Nigeria., Olateju EK; Department of Paediatrics, University of Abuja Teaching Hospital, Gwagwalada, Nigeria., Baba FJ; Department of Paediatrics, Jos University Teaching Hospital, Jos, Nigeria., Medupin PF; Department of Paediatrics, Federal Medical Centre, Lokoja, Nigeria., Ahmed G; Department of Paediatrics, Federal Medical Centre, Bida, Nigeria., Ango S; Department of Paediatrics, Federal Medical Centre, Keffi, Nigeria., Akaba G; Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Gwagwalada, Nigeria., Ogunkunle TO; Department of Paediatrics, Dalhatu Arafa Specialist Hospital, Lafia, Nigeria., Agada E; Department of Paediatrics, Federal Medical Centre, Makurdi, Nigeria., Gibbons L; Department of Mother & Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina., Oladapo OT; Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, World Health Organization, Geneva, Switzerland., Lavin T; Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, World Health Organization, Geneva, Switzerland., Tukur J; Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria., Aboyeji AP; Department of Obstetrics & Gynaecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Jazyk: angličtina
Zdroj: BJOG : an international journal of obstetrics and gynaecology [BJOG] 2024 Aug; Vol. 131 Suppl 3, pp. 78-87. Date of Electronic Publication: 2024 Apr 04.
DOI: 10.1111/1471-0528.17815
Abstrakt: Objective: To describe the outcomes and quality of care for women and their babies after caesarean section (CS) in Nigerian referral-level hospitals.
Design: Secondary analysis of a nationwide cross-sectional study.
Setting: Fifty-four referral-level hospitals.
Population: All women giving birth in the participating facilities between 1 September 2019 and 31 August 2020.
Methods: Data for the women were extracted, including sociodemographic data, clinical information, mode of birth, and maternal and perinatal outcomes. A conceptual hierarchical framework was employed to explore the sociodemographic and clinical factors associated with maternal and perinatal death in women who had an emergency CS.
Main Outcome Measures: Overall CS rate, outcomes for women who had CS, and factors associated with maternal and perinatal mortality.
Results: The overall CS rate was 33.3% (22 838/68 640). The majority of CS deliveries were emergency cases (62.8%) and 8.1% of CS deliveries had complications after delivery, which were more common after an emergency CS. There were 179 (0.8%) maternal deaths in women who had a CS and 29.6% resulted from complications of hypertensive disorders of pregnancy. The overall maternal mortality rate in women who delivered by CS was 778 per 100 000 live births, whereas the perinatal mortality at birth was 51 per 1000 live births. Factors associated with maternal mortality in women who had an emergency CS were being <20 or >35 years of age, having a lower level of education and being referred from another facility or informal setting.
Conclusions: One-third of births were delivered via CS (mostly emergency), with almost one in ten women experiencing a complication after a CS. To improve outcomes, hospitals should invest in care and remove obstacles to accessible quality CS services.
(© 2024 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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