DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20175230

Factors associated with caesarean section at Bukavu Provincial Hospital in Democratic Republic of Congo

Mulongo Mbarambara Philémon, Mwamini Chumbika Julie, Mukanire Ntakwinja, Kyambikwa Bisangamo Célestin, Mvula Mwantito Théodore

Abstract


Background: Caesarean section is the most common major surgery performed on women Worldwide. Even if caesarean can be useful for mother and foetus, it can provoke some medical and social complications like infection, expensive cost and maternal death. This study aimed at determining the factors associated with caesarean section in Bukavu, at the Provincial Hospital.

Methods: Data were collected retrospectively by exploring the files of childbirth established systematically for each pregnant woman. 466 files were exploited including 233 caesarean s (case) and 233 vaginal delivery (control). The normal childbirth which followed a caesarean was served as control. This study was a case-control. Logistic regression was used to model factor associated with caesarean section.

Results: During the study period, there were 2170 deliveries in which 491 of them by caesarean section (22.6%). The factors associated with the caesarean section at the Provincial Hospital in Bukavu town were foetal distress, bleeding in the third trimester of the pregnancy, previous caesarean section, referral status and the moment of delivery (day shift).

Conclusion: This study recommends an adequate monitoring of the pregnancy and training of professionals in best practices; implementation and technical audit of caesarean with feedback can significantly reduce the rate of Caesarean section in this hospital. Also, allocation in equipment suitable for the treatment of pregnant women is necessary.


Keywords


Case control, Caesarean section, Factor associated, Provincial hospital

Full Text:

PDF

References


Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Murray CJ. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet. 2010;375:1609-23.

WHO, UNFPA and the World Bank. Trends in maternal mortality: 1990 to 2008. Estimates developed by WHO, UNICEF. 2010.

Mushira US, Ramanathan M. Delivery-related complications and determinants of caesarean section rates in India. Health Policy Planning. 2002;17(1):90-8.

World Health Organization and UNICEF. Indicators to monitor maternal health goals: Report of a technical working group, Geneva, 8-12 November 1993. 1994. Available at http://apps.who.int/iris/handle/10665/60261 Accessed 16 October 2015.

Menacker F, Declercq E, Macdorman MF. Cesarean delivery: background, trends, and epidemiology. Seminars in perinatology. 2006;30(5):235-24.

Leone T, Padmadaas SS, Mathews Z. Community factors affecting rising caesarean section rates in developing countries: an analysis of six countries. Social Science Med. 2008;67(8):1236-46.

Althabe F, Sosa C, Belizan JM, Gibbons L, Jacquerioz F, Bergel E. Caesarean section rates and maternal and neonatal mortality in low, medium, and high-income countries: an ecological study. Birth. 2006;33(4):270-7.

Stanton CK, Holtz SA. Levels and trends in cesarean birth in the developing world. Stud Fam Plan. 2006;37(1):41-8.

Dumont A, de Bernis L, Bouvier-Colle MH, Breart G, MOMA Study Group: Caesarean section rate for maternal indication in sub-Saharan Africa: a systematic review. Lancet. 2001;358(9290):1328-33.

Moore B. Appropriate technology for birth. Lancet. 1985;326(8458):87.

Gibbons L, Belizan J, Lauer J, Betran A. Inequities in the use of caesarean sections in the World. Am J Obstet Gynecol. 2012;206:331.

Gholitabar M, Ullman R, James D, Griffiths M: Guideline development group of the national institute for health and clinical excellence: caesarean section: summary of updated NICE guidance. BMJ. 2011;343:d7108.

Kongnyuy EJ, Hofman JJ, van den Broek N. Ensuring effective essential obstetric care in resource poor settings. BJOG. 2009;116(1):41-7.

Deboutte D, O'Dempsey T, Mann G, Faragher B. Cost‐effectiveness of caesarean sections in a post‐conflict environment: a case study of Bunia, Democratic Republic of the Congo. Disasters. 2013;37(1):S105-20.

Chu K, Cortier H, Maldonado F, Mashant T, Ford N, Trelles M. Cesarean Section rates and indications in Sub-Saharan Africa: a multi-country study from Médecins sans Frontieres. PLoS ONE. 2012;7(9):e44484.

Busaidi A, Al-Farsi Y, Ganguly S, Gowri V. Obstetric and non-obstetric risk factors for cesarean section in Oman. Oman Med J. 2012;27(6):478-481.

Akinola OI, Fabamwo AO, Tayo AO, Rabiu KA, Abisomo OY, Alokha ME. Caesarean section: an appraisal of some predictive factors in Lagos Nigeria. BMC Pregnancy Childbirth. 2014;14(1):217.

Mendoza-Sassi RA, Cesar JA, Silva PR, Denardin G, Rodrigues MM. Risk factors for cesarean section by category of health service. Rev Saude Publica. 2010;44(1):80-9.

Patel RR, Peters TJ, Murphy DJ and the ALSPAC Study Team. Prenatal risk factors for caesarean section. Analyses of the ALSPAC cohort of 12944 women in England. Int J Epidemiol. 2005;34:353-67.

Tebeu PM, Mboudou E, Halle G, Kongnyuy E, Nkwabong E, Fomulu JN. Risk factors of delivery by caesarean section in Cameroon (2003-2004): a regional hospital report. ISRN obstetrics and gynecology. 2011;2011.

Geldam AD, Audu BM, Kawuwa BM, Obed JY. Rising trend and indicators of caesarean section at the University of Maiduguri teaching hospital, Nigeria. Ann Afr Med. 2009;8(2):127-32.

Freitas PF. The epidemic of caesarean sections in Brazil, factors influencing type of delivery in Florianópolis, South Brazil. Londres: Universidade de Londres; 1999.

Bakkali ME, Azzouzi Y, Khadmaoui A, Ahami AO, Boubel O. The risk factors associated with the practice of caesarean section in pregnant women at the maternity hospital of IDRISSI Hospital in the Gharb Morocco region. European Sci J. 2014;10(9):226-37.

Rageth JC, Juzi C, Grossenbacher H. Delivery after previous cesarean: a risk evaluation. Swiss Working Group of Obstetric and Gynecologic Institutions. Obstet Gynecol. 1999;93:332-7.

Talas BB, Altinkaya SO, Talas H, Danisman N, Gungor T. Predictive factors and short-term fetal outcomes of breech presentatiom: a case-control study. Taiwan J Obstet Gynecol. 2008;47 (4):402-7

Strong TH, Phelan JP, Alm MO, Sarno AP. Vaginal birth after cesarean delivery in the twin gestation. Am J Obste Gynecol.1989;161(1):29-32.

Sorbye IK, Vangen S, Oneko O, Sundby J, Bergsjo P. Caesarean section among referred and self-referred birthing women: a cohort study from a tertiary hospital, northeastern Tanzania. BMC Pregnancy Childbirth. 2011;1:55.