Cesarean delivery surveillance system at a maternity hospital in Kabul, Afghanistan
Kandasamy, T.; Merialdi, M.; Guidotti, R.J.; Betrán, A.P.; Harris-Requejo, J.; Hakimi, F.; Van Look, P.F.; Kakar, F.
International Journal of Gynaecology and Obstetrics the Official Organ of the International Federation of Gynaecology and Obstetrics 104(1): 14-17
2009
ISSN/ISBN: 0020-7292 PMID: 18926535 DOI: 10.1016/j.ijgo.2008.08.024Document Number: 206466
To use an active facility-based maternal and newborn surveillance system to describe cesarean delivery practices and outcomes in a resource-poor setting. Using data from operating room logbooks, 392 cesarean deliveries were evaluated between April 1 and June 30 2006 at a large public maternity hospital in Kabul, Afghanistan. The perinatal mortality rate was 89 per 1000 births: 57% antepartum and 37% intrapartum stillbirths. Fetuses with normal birth weight comprised 85% of intrapartum stillbirths. Obstructed labor, uterine rupture, and malpresentation accounted for more than 50% of perinatal deaths. The cesarean delivery rate was 10.2% and there were 2 maternal deaths. The high percentage of intrapartum stillbirths among normal birth weight fetuses suggests a need for improved labor monitoring and surgical obstetric practices. The use of a facility-based perinatal surveillance system is critical in guiding such quality assurance initiatives.
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