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The death rate of women undergoing cesarean delivery is about 50 times higher in Africa than in most rich countries, researchers said Friday.
One in every 200 women die during or shortly after cesarean delivery from nearly 3,700 births in 22 African countries, reported The Lancet Global Health.
In comparison, maternal mortality is about one woman per 10,000 operations in Britain. Caesarean section mortality rates are about the same in most developed countries.
Urgent need to improve security
"The results underscore the urgent need to improve the safety of the procedure," said researchers led by Bruce Biccard, a professor at the University of Cape Town, South Africa.
The preventable deaths related to cesarean section were mainly due to uterine rupture, to mothers who had previously had placental complications, to bleeding before birth or during an operation and to problems related to the caesarean section. anesthesia.
"Improving the surgical results of cesarean section could dramatically improve maternal and neonatal mortality," said Biccard.
He also called for a better badessment of the risk of bleeding and less restrictive use of drugs to treat postpartum hemorrhage.
In many African countries, there is a chronic shortage of blood for transfusions.
Blood products with a longer shelf life and better use of anesthesia by non-physicians – via mobile and online training, for example – could also help to increase survival rates, the researchers said. researchers.
Surgical study
The findings are part of the Africa Surgical Outcomes Study, which tracks all operated patients from 183 hospitals in 22 countries for seven days.
The study found that caesareans accounted for one-third of all surgeries during the period covered.
Making caesareans more readily available could also prevent life-threatening complications, noted the authors.
Of the cases reviewed, 75% were clbadified as "emergency surgery", with mothers arriving in the operating room with high-risk conditions.
"Paradoxically, as many countries seek to reduce cesarean delivery rates, their increase remains a priority in Africa," said Biccard.
Double Caesarean section worldwide
Globally, the number of caesarean sections has nearly doubled in the last 20 years, reaching unprecedented proportions in some countries, highlighted recent research.
In Brazil, Egypt and Turkey, for example, more than half of all births take place by caesarean section.
But in almost a quarter of the countries studied, many in Africa, the use of the procedure is well below average.
It is estimated that the operation is medically necessary 10-15% of the time.
In 2015, doctors performed 29.7 million caesareans worldwide, representing 21% of all births.
This represented 16 million people in 2000, representing 12% of all births.
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