The effects of previous cesarean deliveries on severe maternal and adverse perinatal outcomes at a university hospital in Tanzania

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• 作者：Helena Litorp^a ; ^{helena.litorp@kbh.uu.se" class="auth_mail" title="E-mail the corresponding author} ; Mattias Rö ; ö ; st^a ; Hussein L. Kidanto^a ; ^b ; Lennarth Nyströ ; m^c ; Birgitta Essé ; n^a
• 关键词：Cesarean section ; Low-income countries ; Maternal near-miss ; Previous scar ; Tanzania
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：133
• 期：2
• 页码：183-187
• 全文大小：353 K

文摘

To investigate if multiparous individuals who had undergone a previous cesarean delivery experienced an increased risk of severe maternal outcomes or adverse perinatal outcomes compared with multiparous individuals who had undergone previous vaginal deliveries.

Methods

An analytical cross-sectional study at a university hospital in Dar es Salaam, Tanzania, enrolled multiparous participants of at least 28 weeks of pregnancy between February 1 and June 30, 2012 . Data were collected from patients’ medical records and the hospital’s obstetric database. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to compare outcomes among patients who had or had not undergone previous cesarean deliveries.

Results

A total of 2478 patients were enrolled. A previous cesarean delivery resulted in no increase in the risk of severe maternal outcomes (OR 0.86, 95% CI 0.58–1.26; P = 0.46), and decreased risk of stillbirth (OR 0.42, 95% CI 0.29–0.62, P < 0.001), and intrapartum stillbirth and neonatal distress (OR 0.58, 95% CI 0.38–0.87, P = 0.007).

Conclusion

Previous cesarean delivery was not a risk factor for severe maternal outcomes or adverse perinatal outcomes. The present study was conducted at a referral institution, where individuals with previous cesarean deliveries may constitute a healthy group. Additionally, there could be differences between the study groups in terms of healthcare-seeking behavior, referral mechanisms, intrapartum monitoring, and clinical decision making.