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Perinatal outcomes ...
Perinatal outcomes of cesarean deliveries in Sierra Leone : A prospective multicenter observational study
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- van Duinen, Alex J. (author)
- Norwegian University of Science and Technology,St. Olav’s University Hospital
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- Westendorp, Josien (author)
- Norwegian University of Science and Technology,University Medical Center Utrecht
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- Kamara, Michael M. (author)
- University of Sierra Leone,Ministry of Health and Sanitation, Sierra Leone
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- Forna, Fatu (author)
- World Health Organization, Sierra Leone
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- Hagander, Lars (author)
- Lund University,Lunds universitet,Pediatrik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Kirurgi och folkhälsa,Forskargrupper vid Lunds universitet,Barnkirurgi,Paediatrics (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Surgery and public health,Lund University Research Groups,Pediatric surgery,Skåne University Hospital
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- Rijken, Marcus J. (author)
- University Medical Center Utrecht
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- Leather, Andrew J.M. (author)
- King's College London
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- Wibe, Arne (author)
- Norwegian University of Science and Technology,St. Olav’s University Hospital
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- Bolkan, Håkon A. (author)
- St. Olav’s University Hospital,Norwegian University of Science and Technology
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Norwegian University of Science and Technology St Olav’s University Hospital (creator_code:org_t)
- 2020-05-29
- 2020
- English 9 s.
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In: International Journal of Gynecology and Obstetrics. - : Wiley. - 0020-7292 .- 1879-3479. ; 150:2, s. 213-221
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Abstract
Subject headings
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- Objective: To analyze the indications for cesarean deliveries and factors associated with adverse perinatal outcomes in Sierra Leone. Methods: Between October 2016 and May 2017, patients undergoing cesarean delivery performed by medical doctors and associate clinicians in nine hospitals were included in a prospective observational study. Data were collected perioperatively, at discharge, and during home visits after 30 days. Results: In total, 1274 cesarean deliveries were included of which 1099 (86.3%) were performed as emergency surgery. Of the 1376 babies, 261 (19.0%) were perinatal deaths (53 antepartum stillbirths, 155 intrapartum stillbirths, and 53 early neonatal deaths). Indications with the highest perinatal mortality were uterine rupture (45 of 55 [81.8%]), abruptio placentae (61 of 85 [71.8%]), and antepartum hemorrhage (8 of 15 [53.3%]). In the group with cesarean deliveries performed for obstructed and prolonged labor, a partograph was filled out for 212 of 425 (49.9%). However, when completed, babies had 1.81-fold reduced odds for perinatal death (95% confidence interval 1.03–3.18, P-value 0.041). Conclusion: Cesarean deliveries in Sierra Leone are associated with an exceptionally high perinatal mortality rate of 190 per 1000 births. Late presentation in the facilities and lack of adequate fetal monitoring may be contributing factors.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Keyword
- Cesarean delivery
- Fetal monitoring
- Partograph
- Perinatal death
- Perinatal mortality
- Stillbirth
Publication and Content Type
- art (subject category)
- ref (subject category)
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