Prophylactic and emergency cesareans: a comparative study on 718 observations at the maternity ward of Ignace Deen National hospital

Ibrahima S. Balde, Roland Adjoby, Mamadou Hady Diallo, Ousmane Balde


Background: The objective of the study is to compare the frequency, the socio-demographic characteristics, the indications, the fetal maternal prognosis and the Robson classification of prophylactic and emergency caesarean sections.

Methods: This was a comparative study of prophylactic and emergency caesarean sections at the maternity of Ignace Deen national hospital. It was a 12 month (July 1, 2016 to June 30, 2017) descriptive and analytical study.

Results: Prophylactic caesarean sections accounted for 12, 51% of caesarean sections and 3.96% of deliveries at the ward. Prophylactic caesarean sections involved pregnant women aged from 20 to 29, holder of higher education degrees (51.54%), married (92.76%) employed (56.83%) and whose prenatal visit was provided by the obstetrician (73.54%). While the emergency caesarean section concerned parturient aged between 20 and 34, mostly non-schooled (36.49%), transferred patients (80.22%) and nulliparous (58.5%). Surgical indications were mainly scarred uterus (32.32%) and maternal pathologies (18.11%) prophylaxis; bleeding in the last quarter (25.90%) acute fetal distress (20.33%) in emergency. Groups 6 and 5 of the Robson classification were the most represented with a 2.23% morbidity and a zero maternal lethality in prophylaxis versus groups 5 and 6 with a 10.03% morbidity and a 1.67% maternal lethality in emergency.

Conclusions: Improving this prognosis would be achieved through an increase in the frequency of prophylactic caesarean sections.


Emergency caesarean section, Ignace-Deen, Maternal and fetal prognosis, Prophylactic caesarean section

Full Text:



Keita N, Diallo FD, Gandaho E, Leno DWA. Caesarean section in Africa: an example from Guinea. CNGOF Part IV gynecology-obstetrics of the World, 38th National day Paris; 2014:259-346.

EDS 3 National Institute of Statistics, Ministry of Planning Conakry- Guinea: a demographic and health survey and multiple indicator cluster survey (EDS-mics 2005) Calverton, Maryland, USA; 2005.

EDS 5 Institute National de la Statistique, Ministère du plan Conakry-Guinea: Enquête démographique et de santé et à indicateurs multiples (EDS-mics 2016) Calverton, Maryland, USA; 2017.

EDS 2012 National Institute of Statistics, Ministry of Planning Conakry-Guinea: Demographic and Health Survey and Multiple Indicator Cluster Survey (EDS-mics 2012) Calverton, Maryland, USA; 2013.

Bokossa M, Nguessan K, Doumbia Y, Kakou C, Djoubou C. Prophylactic and emergency caesarean sections for 394 cases at the Cocody University Hospital. Med Afr Noire. 2008:55(11):591-601.

Xavier K, Olivier M, Faustin C, Prosper K, Banzulu P, Jean-Baptiste K, et al. Césarienne à Lubumbashi, République Démocratique du Congo: fréquence, indications et mortalité maternelle et périnatale. The Pan Afr Med J. 2017:270-90.

Ouédraogo CM, Ouédraogo A, Ouattara A, Lankoandé J. The practice of caesarean section in a district hospital in Ouagadougou: epidemiological, clinical and prognostic aspects: about 3381 cases. Trop Med Health. 2015;25(2):194-9.

Organization for Economic Co-operation and Development. Geographic variations in health care: what do we know and what can be done to improve health system performance?. OECD Publishing; 2014.

Tadesse E, Adane M, Abiyou M. caesarian section deliveries at Tikur Anbessa Teaching hospital Ethiopia. East Afr med J. 1996;73:619-22.

Bibi M, Maghdiche H, Ghanem H. antibiotic prophylaxis in caesarean sections without a high risk of infection, experience of a Tunisian maternity ward. J Gynecol Obstet Biol Reprod. 1994;23:451-5.

Foumane P, Mve Koh V, Ze Minkande J, Njofang Ngantcha EA, Dohbit JS, Mboudou ET. Risk factors and prognosis of emergency caesarean sections at the gynaecological-obstetric and paediatric hospital of Yaoundé (Cameroon). Trop Health Med. 2014;24(1):89-93.

Thiam O, Cissé ML, Mbaye MM, Niang MM, Gueye M, Diouf AA, et al. The problem of evacuated parturients in rural Senegalese areas: example of the Ndioum hospital centre. Rev Cames Sante. 2013;1(2):51-6

Tshabu-Aguèmon, Denakpo J, Adisso S, Mampassi E, De Souza J. Maternal and perinatal mortality linked to obstetrical references to the CUGO of the CNHU-HKM of Cotonou. RAMUR. 2012;17(1):1.

Etienne B, Pascal F, Dohbit SJ, Ngo Um EM, Kiyeck DK, Mboudou ET. Prognosis of obstetrical referrals to the Yaounde Gynaeco-Obstetric and Paediatric Hospital (HGOPY). Pan Afr Med J. 2017;28:301-7.

Baldé BO, Hyjazi Y, Diallo M, Diop MD, Keita N. Prognosis of obstetrical referrals to the gynaeco-caesarean Hospital in the obstetrical practice at the Donka gynaecology and obstetrics clinic of the Conakry University Hospital: Frequency and problems. Guinée Méd. 2003:33-8.

Mounanga M, Nzoghe P, Adjovi J, Zinsou RD. Caesarean section: retrospective study of 274 cases. Med Afr Noire. 1986;33(3):180-8.

Foumane P, Belinga E, Hafizatou M, Dohbit JS, Ngo Um ME, Mboudou ET. Risk factors of poor outcome of pregnancy and delivery in adolescents: a case-control study at the Yaounde gynaeco-obstetric and pediatric hospital. Int J Reprod Contracept Obstet Gynecol. 2016;5(7):2228-32.

Racinet CI, Favier M. Caesarean section: Indication, techniques, complications. Paris: Masson. 1984:160-4.

Graizin E. Conservation in obstétrics. Ny Med J. 1916:Ci(V):1-5.

Baldé IS, SY T, Diallo FB, Diallo Y, Conté I, Diallo MS. Iterative caesarean section: sociodemographic, clinical and prognostic aspects at the gynaecology-obstetrics Ignace-Deen clinic of Conakry Teaching Hospital . Guinée Méd. 2010;69:41-8 .

Baldé IS, SY T, Diallo A, Baldé O, Diallo MH, Diallo MS, et al. Childbirth in the context of a scarred uterus at the maternity ward of the Ignace-Deen National Hospital (Guinea). Rev Méd Périnat. 2017;9:32-6.

Kaba A, Balde IS, Sy T, Diallo Y, Keita S, Hyjazi Y et al. Misgav-Ladach caesarean section versus conventional caesarean section with median sub umbilical laparotomy: comparative study of 372 caesarean section cases at Conakry University Hospital. Ann de la SOGO. 2007;9(2):80-7.

Subtil D, Vaast P, Dufour P, Depret-Mosser S, Codaccioni X, Puech F. Maternal consequences of caesarean section versus vaginal delivery. J Gynécol Obstét Biol Reprod. 2000;29(2):10-1.

Van Ham MA, Van Dongen PW, Mulder J. Maternel consequences of caesarean section. A retrospective Study of intra operative maternal complications of caesarean section during a 10 years period. Eur Obstét Gynécol Biol. 1997;74:1-6.

Ladaique A, Leroch A, Deruelle P. Maternal and fetal risks of scheduled and emergency caesarean section. Pelvi-Périnéol. 2009;4:200-6.

Boulanger JC, Vist M, Berh VB, Cauner B, Caron C, Firmin JM. Maternal C-sections complications, J Gynécol Obstét Biol Reprod. 1986;15:327.