cesarean section rates and indications in sub-saharan africa a multi-country study from medecins sans frontieres剖腹产率和迹象在撒哈拉以南非洲多国来自无国界医生组织的研究.pdfVIP

Cesarean Section Rates and Indications in Sub-Saharan Africa: A Multi-Country Study from Medecins sans Frontieres 1,2 3 4 5 1,6 Kathryn Chu *, Hilde Cortier , Fernando Maldonado , Tshiteng Mashant , Nathan Ford , Miguel Trelles3 ´ ` 1 Medecins sans Frontieres, Johannesburg, South Africa, 2 Departments of Surgery and International Health, Johns Hopkins University, Baltimore, Maryland, United States ´ ` ´ ` ´ of America, 3 Medecins sans Frontieres, Medical Department, Brussels, Belgium, 4 Medecins sans Frontieres, Kinshasa, Democratic Republic of Congo, 5 Medecins sans ` Frontieres, Bujumbura, Burundi, 6 Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa Abstract Objectives: The World Health Organization considers Cesarean section rates of 5–15% to be the optimal range for targeted provision of this life saving intervention. However, access to safe Cesarean section in resource-limited settings is much lower, estimated at 1–2% reported in sub-Saharan Africa. This study reports Cesarean sections rates and indications in Democratic Republic of Congo, Burundi, and Sierra Leone, and describe the main parameters associated with maternal and early neonatal mortality. Methods: Women undergoing Cesarean section from August 1 2010 to January 31 2011 were included in this prospective study. Logistic regression was used to model determinants of maternal and early neonatal mortality. Results: 1276 women underwent a Cesarean section, giving a frequency of 6.2