The mortality rate of women giving birth to a child in a caesarean section is about 50 times higher in Africa than in most affluent countries, researchers said Friday.
One in 200 women died during or shortly after a caesarean section on a sample of almost 3,700 births in 22 African countries, they reported in The Lancet Global Health.
In comparison, maternal mortality in the UK is about one woman per 10,000 operations. In most industrialized countries, the mortality rates for caesarean sections are about the same.
Urgency in the improvement security
"The findings underscore the urgent need for improved safety of the procedure," said researchers around Bruce Biccard, a professor at the University of Cape Town in South Africa.
Preventable deaths in Section C were mostly from a broken uterus, in mothers who had placental complications, bleeding before birth or during surgery, and had problems with anesthesia.
"Improving Caesarean surgical outcomes could significantly improve both maternal and neonatal mortality," said Biccard.
He also called for a better assessment of the risk of bleeding and a less restrictive use of drugs to treat postpartum bleeding.
In many African countries, there is a chronic short blood supply for transfusions.
Non-physician blood products with longer shelf life and better use of anesthesia – for example through mobile and online training – could also help increase survival, researchers said.
Increasing the C sections is a priority
The findings are part of the Africa Surgical Outcomes Study, which covers all patients who have been operated on at seven days in 183 hospitals in the 22 countries.
The study found that C-sections accounted for one third of all operations during the study period.
By facilitating the availability of C-sections, potentially fatal complications could be avoided.
Of the cases examined, 75% were classified as "emergency operations", with mothers arriving in the operating room under risk conditions.
"Paradoxically, the rate of increase in Africa is prioritized in Africa," said Biccard.
More and more procedures carried out
Worldwide, the number of C-profiles has almost doubled in the last 20 years, reaching unprecedented levels in some countries, as recent research has shown.
In Brazil, Egypt and Turkey, for example, more than half of all births are performed via cesarean section.
However, in almost a quarter of the nations surveyed – many in Africa – the application of the procedure is well below average.
It is estimated that surgery is medically necessary in 10% to 15% of the time.
In 2015, doctors performed 29.7 million Caesarean sections worldwide – 21% of all births.
This was an increase of 16 million in 2000 or 12% of all births.
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