“Maternal and Fetal Health Outcomes of Cesarean Sections (CS) in Ethiopia: Results from Retrospective Cross-sectional study of Southern Ethiopia Gurage Zone Governmental Hospitals”
Helina Mesfin1,5*, Roza Teshome2, Haweni Adugna2, Ermiyas Belay3,5, Fitsum Kifle4,5
1Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.
2Department of Midwifery, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
3Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.
4Division of Global Surgery, University of Cape Town, South Africa
5Network For Perioperative and Critical Care, Addis Ababa, Ethiopia.
Helina Mesfin Belay
Wolkite University, Wolkite, Ethiopia. Email: helinamesfin25@gmail.com; Tel: +251920738109
Abstract
Background: The most common obstetric surgery performed nowadays is a cesarean section. Despite the fact that cesarean delivery is the safest mode of delivery in high-risk scenarios, it also appears to have a higher risk of maternal and newborn morbidity and mortality than vaginal delivery, and in low-resource settings, the risks are doubled. In this study we
investigated fetal and maternal outcomes following Caesarean sections in southern Ethiopia, specifically in the Gurage region, to better understand and quantify the prevalence of these outcomes and to provide recommendations based on the findings.
Methods: Institutional based retrospective cross-sectional study was conducted in Gurage Zone governmental hospitals from February 21/2021- March 13/2021 on the hospital medical records of mothers who delivered by cesarean section from February 2019 to January 2021. The total sample size was 398 and collected from five governmental hospitals. The collected data was entered and analyzed using STATA version 15. Binary and Multiple Logistic regressions were used to identify associated factors for maternal outcome and fetal outcome.
Results: Out of mothers included in the study, 86 (23.4%) had poor maternal outcomes. The prevalence of poor fetal outcome was 75 (19.74%). Obstetric complications, medical diseases, and Ante Partum Hemorrhage as an indication for Cesarean Section are statistically significant factors for poor maternal outcomes. Also, Medical disease and Cephalic Pelvic Disproportion as an indication for Cesarean Section are statistically significant factors for poor fetal outcome.
Conclusion & Recommendation: The numbers are not uniformly high or low when compared to other regions of Ethiopia, but they are closely related, suggesting a need for immediate collaborative evidence-based interventions to improve hospital capacities and preoperative optimization strategies, since pregnancy-related complications, preoperative hemorrhages,
and preoperative medical conditions all contributed to poor maternal and neonatal outcomes.
Keywords: Cesarean section, In hospital, outcomes, Maternal Complication.