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Published in: BMC Pregnancy and Childbirth 1/2007

Open Access 01-12-2007 | Research article

Caesarean section in a semi-rural hospital in Northern Namibia

Authors: Jeroen van Dillen, Tarek Meguid, Vera Petrova, Jos van Roosmalen

Published in: BMC Pregnancy and Childbirth | Issue 1/2007

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Abstract

Background

Increasing caesarean sections rates (CSR) are a major public health concern and the prevention of the first caesarean section, which often leads to repeat operations, is an important issue. Analyzing caesarean sections can help to identify factors associated with variations in CSR and help to assess the quality of clinical care.

Methods

In a retrospective observational study, during a two year period, indications of 576 caesarean sections were analyzed using intra-operative internal pelvimetry and a record keeping system in a semi-rural hospital in Northern Namibia.

Results

Most caesarean sections were done for dystocia (34%) followed by repeat caesarean section (31%). The true conjugate (distance between the promontorium to mid pubic bone) was significantly smaller in these recurrent indication groups when compared to non recurrent indications.

Conclusion

In this rural hospital the introduction of Delee Pelvimetry and a caesarean section record keeping system was found to be a simple and cheap method to analyse indications for caesarean sections, which may help in reducing unnecessary caesarean sections.
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Literature
1.
go back to reference Declercq E, Menacker F, MacDorman M: Rise in "no indicated risk" primary caesareans in the United States, 1991–2001: cross sectional analysis. BMJ. 2005, 330: 71-2. 10.1136/bmj.38279.705336.0B.CrossRefPubMedPubMedCentral Declercq E, Menacker F, MacDorman M: Rise in "no indicated risk" primary caesareans in the United States, 1991–2001: cross sectional analysis. BMJ. 2005, 330: 71-2. 10.1136/bmj.38279.705336.0B.CrossRefPubMedPubMedCentral
2.
go back to reference Thomas J: The National Sentinel Caesarean Section Audit Report. Royal College of Obstetricians and Gynaecologists Clinical Effectiveness Support Unit. 2001, London: RCOG Press Thomas J: The National Sentinel Caesarean Section Audit Report. Royal College of Obstetricians and Gynaecologists Clinical Effectiveness Support Unit. 2001, London: RCOG Press
3.
go back to reference Bauer O, Kingu R, Laussen T, Mbwana K: Pelvic assessment and cephalo-pelvic disproportion in Central Tanzania. Int J Gynecol Obstet. 1998, 27: 323-5. 10.1016/0020-7292(88)90107-5.CrossRef Bauer O, Kingu R, Laussen T, Mbwana K: Pelvic assessment and cephalo-pelvic disproportion in Central Tanzania. Int J Gynecol Obstet. 1998, 27: 323-5. 10.1016/0020-7292(88)90107-5.CrossRef
4.
go back to reference Adadevoh SWK, Hobbs C, Elkins TE: The relation of the true conjugate to the maternal height and obstetric performance in Ghanaians. Int J Gynecol Obstet. 1989, 28: 243-51. 10.1016/0020-7292(89)90725-X.CrossRef Adadevoh SWK, Hobbs C, Elkins TE: The relation of the true conjugate to the maternal height and obstetric performance in Ghanaians. Int J Gynecol Obstet. 1989, 28: 243-51. 10.1016/0020-7292(89)90725-X.CrossRef
5.
go back to reference Burgess HA: Anthropometric measures as a predictor of cephalopelvic disproportion. Trop Doct. 1997, 27: 135-PubMed Burgess HA: Anthropometric measures as a predictor of cephalopelvic disproportion. Trop Doct. 1997, 27: 135-PubMed
6.
go back to reference Liselele HB, Tshibangu CK, Meuris S: Association between external pelvimetry and vertex delivery complications in African women. Acta Obstet Gynecol Scand. 2000, 79: 673-8. 10.1034/j.1600-0412.2000.079008673.x.PubMed Liselele HB, Tshibangu CK, Meuris S: Association between external pelvimetry and vertex delivery complications in African women. Acta Obstet Gynecol Scand. 2000, 79: 673-8. 10.1034/j.1600-0412.2000.079008673.x.PubMed
7.
go back to reference Van Roosmalen J, Brand R: Maternal height and the outcome of labor in rural Tanzania. Int J Gynecol Obstet. 1992, 37: 169-77. 10.1016/0020-7292(92)90377-U.CrossRef Van Roosmalen J, Brand R: Maternal height and the outcome of labor in rural Tanzania. Int J Gynecol Obstet. 1992, 37: 169-77. 10.1016/0020-7292(92)90377-U.CrossRef
8.
go back to reference Tbushi M, Ebrahim A, Moodley J, Shweni PM: Vaginal delivery after previous caesarean section: is X-ray pelvimetry necessary?. Br J Obstet Gynaecol. 1993, 100: 421-4.CrossRef Tbushi M, Ebrahim A, Moodley J, Shweni PM: Vaginal delivery after previous caesarean section: is X-ray pelvimetry necessary?. Br J Obstet Gynaecol. 1993, 100: 421-4.CrossRef
9.
go back to reference Van Loon AJ, Mantingh A, Elvira KS, Kroon G, Mooyaart EL, Huisjes HJ: Randomised controlled trial of magnetic resonance pelvimetry in breech presentation at term. Lancet. 1997, 350: 1799-1804. 10.1016/S0140-6736(97)05431-7.CrossRefPubMed Van Loon AJ, Mantingh A, Elvira KS, Kroon G, Mooyaart EL, Huisjes HJ: Randomised controlled trial of magnetic resonance pelvimetry in breech presentation at term. Lancet. 1997, 350: 1799-1804. 10.1016/S0140-6736(97)05431-7.CrossRefPubMed
10.
go back to reference Philpott RH: The recognition of cephalopelvic disproportion. Clin Obstet Gynaecol. 1982, 3: 609-24. Philpott RH: The recognition of cephalopelvic disproportion. Clin Obstet Gynaecol. 1982, 3: 609-24.
11.
12.
go back to reference Pattinson RC: Pelvimetry for fetal cephalic presentations at term. Cochrane Database Syst Rev. 2000 Pattinson RC: Pelvimetry for fetal cephalic presentations at term. Cochrane Database Syst Rev. 2000
13.
go back to reference Meguid T: Routine manual pelvimetries before labour in cephalic presentations in primigravidae: a personal opinion. PHC In Action. 2002, 11: 25-6. Meguid T: Routine manual pelvimetries before labour in cephalic presentations in primigravidae: a personal opinion. PHC In Action. 2002, 11: 25-6.
14.
go back to reference Meguid T, Ikeakanam OTO, Petrova VA: Lessons learned from two year of in-service-training for midwives at Onandjokwe hospital in northern Namibia. Int J Gynecol Obstet Suppl. 2000, 70: 4;59- Meguid T, Ikeakanam OTO, Petrova VA: Lessons learned from two year of in-service-training for midwives at Onandjokwe hospital in northern Namibia. Int J Gynecol Obstet Suppl. 2000, 70: 4;59-
15.
go back to reference Wilder-Smith A: Current Status of 'Essential Obstetric Care' activities internationally: a literature review. Trop Doct. 2003, 33: 135-8.PubMed Wilder-Smith A: Current Status of 'Essential Obstetric Care' activities internationally: a literature review. Trop Doct. 2003, 33: 135-8.PubMed
16.
go back to reference Holmgren G, Sjöholm L, Stark M: The Misgav Ladach method for caesarean section: method description. Acta Obstet Gynecol Scand. 1999, 78: 615-21. 10.1034/j.1600-0412.1999.780709.x.CrossRefPubMed Holmgren G, Sjöholm L, Stark M: The Misgav Ladach method for caesarean section: method description. Acta Obstet Gynecol Scand. 1999, 78: 615-21. 10.1034/j.1600-0412.1999.780709.x.CrossRefPubMed
18.
go back to reference King M: The Surgery of Labour. Primary Surgery. Edited by: King M. 1993, New York: Oxford Medical Publications, 1: 257-92. 2 King M: The Surgery of Labour. Primary Surgery. Edited by: King M. 1993, New York: Oxford Medical Publications, 1: 257-92. 2
19.
go back to reference Dumont A, de Bernis L, Bouvier-Colle MH, Bréart G, MOMA study group: Caesarean section rate for maternal indication in sub-Saharan Africa: a systematic review. Lancet. 2000, 358: 1328-33. 10.1016/S0140-6736(01)06414-5.CrossRef Dumont A, de Bernis L, Bouvier-Colle MH, Bréart G, MOMA study group: Caesarean section rate for maternal indication in sub-Saharan Africa: a systematic review. Lancet. 2000, 358: 1328-33. 10.1016/S0140-6736(01)06414-5.CrossRef
20.
go back to reference Semple DM, Khaled K, Maresh MJA: Monitoring quality of audit in obstetrics and gynaecology. Quality in Health Care. 2000, 9: 37-41. 10.1136/qhc.9.1.37.CrossRefPubMedPubMedCentral Semple DM, Khaled K, Maresh MJA: Monitoring quality of audit in obstetrics and gynaecology. Quality in Health Care. 2000, 9: 37-41. 10.1136/qhc.9.1.37.CrossRefPubMedPubMedCentral
Metadata
Title
Caesarean section in a semi-rural hospital in Northern Namibia
Authors
Jeroen van Dillen
Tarek Meguid
Vera Petrova
Jos van Roosmalen
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2007
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-7-2

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