Caesarean sections of prophylactic indication but performed in emergency at CHU-SO: reasons, maternal and fetal prognosis

Abstract

Cesarean section is an alternative to vaginal delivery. It can be prophylactic or performed urgently. At CHU-SO many parturient with an emergency caesarean should have benefited from a prophylactic caesarean.

Objective: to determine the reasons and the prognostic aspects of caesarean sections of prophylactic indication but performed in emergency

Patients and method: This was a cross-sectional and descriptive study with prospective data collection. It was carried out from April 15 to August 15, 2020 at the CHU-SO maternity unit. It concerned those who had received an emergency cesarean section when they should have had a prophylactic cesarean section.

Results: Out of 1658 by caesarean section, 1000 were performed urgently. 270 should have been prophylactic. Seventy deliveries of 270 were originally scheduled (CIP) and 200 were never scheduled (CNP). The main emergencies were labor and PMR. In the CNP group, uterine scarring and pelvic abnormalities were unrecognized indications. In IPC groups, onset of labor or a complication before the expected date of the cesarean was the cause. The refusal of the cesarean by the pregnant woman was present in both groups. Maternal-fetal complications were more common in the CNP group.

Conclusion: the frequency of caesarean sections for prophylaxis but performed urgently is high. Raising the awareness of pregnant women coupled with strengthening the skills of health personnel are necessary to reduce this frequency.