Trends in the rate and place of caesarean deliveries in a rural district hospital in Burkina Faso: 12-year review

Abstract

Caesarean section is a major obstetric procedure performed in obstetric surgery to save the mother or
child. The objective of this study was to study the clinical, therapeutic and prognostic aspects of cesarean
section performed at the Orodara district hospital (HDO) from 2002 to 2013 in Burkina Faso.
This was a retrospective descriptive study of 2,093 Caesarean sections.
During the 12-year study period, the average annual proportion of cesarean sections was 26.04% (a minimum
of 5.83% in 2003 and a maximum of 47.42% in 2012) and caesarean sections represented 46.89 % (Minimum
of 17.84% in 2003 and maximum of 68.44% in 2013) of interventions carried out in the operating ward of
Orodara Health district. The average age of the cases was 22.73 years [20.21; 25,52]. The most representative
age group was 20 to 24 (24.41%). Fetal pelvic disproportion (PFD) and fetal distress (FS) were the
most commonly reported 47.33% and 22.75%, respectively. Only eight (08) prophylactic caesarean sections
were performed (0.38% of cases). Spinal anesthesia was performed as first-line treatment (94.31%). The
cephalic mode was the most observed mode of extraction (67.12%) followed of the podalic one with (11.18%).
The weight of the child about 63.90% of the cases was between 2500 and 3000 grams. The intra-hospital
maternal lethality in per and post-caesarean was 0.81%. The intra-hospital neonatal lethality in per and postcaesarean
was 11.69%. In 90.04% of the cases, these deaths occurred within 24 hours.
Caesarean section remains a major factor in reducing unmet obstetric needs for reducing maternal and
neonatal morbidity and mortality. Taking into account the shortcomings noted, it must urgent improve the
quality of care and services offered to patients undergoing caesarean sections in order to reduce the unmet
need for obstetric care. More comprehensive data on causality will be a significant aid in order to reduce
maternal and neonatal mortality. The work showed an increase in the proportion of cesarean deliveries at
the district hospital level. Improved quality of delivery should reduce maternal and neonatal mortality in the
health district.