The rate of maternal mortality after caesarean section in Africa would be fifty times higher than in rich countries, according to a study published Friday in the medical journal the Lancet Global Health
This last is part of the African Surgical Outcomes Study, a scientific project aimed to estimate the consequences of the surgery in all the patients operated for seven days in 183 hospitals in 22 african countries. About 3700 women followed, 20 died after their caesarean section, which gives a maternal mortality of 5.43 per 1000 c-sections for african mothers, compared to 0. .1 per 1000 in the United Kingdom. In addition, African women have introduced almost three times more complications during the surgical procedure that the U.
.s. , in particular the risk of bleeding severe. Cesarean sections urgenceDans this study, three-quarters of caesarean sections were done in an emergency. And many of the mothers had a risk preoperative already high due to pregnancy-related complications, such as problems with placental, a rupture of the uterus or bleeding before the birth.
Bleeding obstetric severe during the surgery and complications from anesthesia increase the risk of death after or during a caesarean section. As to the rate of neonatal mortality after caesarean section, the study shows that it reached the double of the world average. “The improvement of surgical outcome of cesarean delivery could significantly reduce maternal and neonatal mortality (death within the first 28 days of life), writes professor Bruce M. . Biccard, of the University of Cape town (South Africa) who led the study. “Improving access to the surgery – and the safety of this procedure could allow patients to present earlier and avoid complications and death,” he continued. Proposals améliorationsDans this perspective, it promotes an early identification of risk of bleeding, and use of less restrictive treatment of post-partum haemorrhage. Of blood products long-term conservation, as well as support online or via mobile applications to the anesthesia performed by non-physicians, could also contribute to increase the survival rate. The number of births by caesarean section has almost doubled in the world in fifteen years, from 12% to 21% between 2000 and 2015, exceeding 40% in 15 countries, according to an analysis published in 2018 in The Lancet.
It is estimated that between 10% and 15% the proportion of c-sections are absolutely necessary for medical reasons. But in many African countries, the share of births by caesarean section remains very low, of the order of 2% to 4%. . “Paradoxically, while many countries seek to reduce the rate of cesarean delivery, the increased rate of caesareans remains a priority in Africa,” notes the professor Biccard.