Volume 3, Issue 4, July 2015, Page: 92-97
Puerperal Morbidity Following Caesarean Section in a Teaching Hospital in Ghana
David Mireku Aduama, Dept of Obstetrics &Gynaecology, Achimota Hospital, Accra, Ghana
Samuel A. Obed, Dept of Obstetrics &Gynaecology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
Joseph D. Seffah, Dept of Obstetrics &Gynaecology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
Solomon K. Gumanga, Dept of Obstetrics &Gynaecology, Tamale Teaching Hospital, University for Development Studies, Tamale, Ghana
Received: Jul. 1, 2015;       Accepted: Jul. 4, 2015;       Published: Jul. 10, 2015
DOI: 10.11648/j.jgo.20150304.15      View  4207      Downloads  140
Abstract
A prospective descriptive study was undertaken to determine the incidence and causes of puerperal morbidity after caesarean section in the department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital from 1st to 30th June 2010. There were a total of 906 deliveries during the study period, of which 299 had caesarean section giving a caesarean section rate of 33%. Primary caesarean section was 57.7%. The incidence of puerperal morbidity after caesarean section was 45.6%. Painful incisional site (21%), puerperal febrile morbidity (16%), depression (12.0%) severe anaemia (12%) Urinary tract infection (6.2%) and wound infections (5.8%) were the leading causes of puerperal morbidities. Other morbidities included hypertensive disorders (4.2%), malaria (3.2%) mastitis (2.5%), postpartum haemorrhage (2.1%), and endometritis (1.2%). Conculsion: There was considerable maternal morbidity after caesarean section at the Korle Bu Teaching Hospital. There is a need for improvements in post operative care to reduce puerperal morbidity following caesarean section; adequate post operative pain management would reduce morbidity to a greater extent.
Keywords
Puerperal, Maternal, Post-Caesarean Section, Postpartum Morbidity
To cite this article
David Mireku Aduama, Samuel A. Obed, Joseph D. Seffah, Solomon K. Gumanga, Puerperal Morbidity Following Caesarean Section in a Teaching Hospital in Ghana, Journal of Gynecology and Obstetrics. Vol. 3, No. 4, 2015, pp. 92-97. doi: 10.11648/j.jgo.20150304.15
Reference
[1]
World Health Organization. Postpartum care of mother and newborn: a practical guide WHO/RHT/MSM/983. Geneva: WHO; 1998.
[2]
Koblinsky MA, Tinker A, Daly P. Programming for safe motherhood: a guide to action. Health Policy Plan. 1994; 9:252–266.
[3]
Chama CM, El-Nafaty AU, Idrisa A. Caesarean morbidity and mortality at Maiduguri, Nigeria. J ObstetGynaecol. 2000; 20:45–48.
[4]
Waterstone M, Wolfe C, Hooper R, Bewley S. Postnatal morbidity after childbirth and severe obstetric morbidity. BJOG. 2003; 110:128–133.
[5]
Fikree FF, Ali T, Durocher JM, Rahbar MH. Health service utilization for perceived postpartum morbidity among poor women living in Karachi. SocSci Med. 2004; 59:681–694. Doi: 10.1016/j.socscimed.2003.11.034.
[6]
Wilkinson C, Mclllwaine G, Boulton-Jones C, Cole S. Is a rising caesarean section rate inevitable? BJOG 1998; 105(1):45-52.
[7]
Dumont A, De Bernis L, Bouvier-ColleMH, Breart G. Caesarean section rate for maternal indication in sub-Saharan Africa: a systematic review. Lancet 2001;358(9290):1328–33
[8]
Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, et al. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet 2006; 367(9525): 1819–29
[9]
Villar J, Carroli G, Zavaleta N, Donner A, Wojdyla D, Faundes A, et al. Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ 2007; 335(7628):1025
[10]
Okonta Pl, Otoide VO, Okogbenin S. Caesarean section at the University of Benin Teaching Hospital revisited. Trop J ObstetGynaecol 2003; 20: 63-66
[11]
Van Ham MA, Van Dongen PW, and Mulder J, Maternal consequences of CS. A retrospective study of intra-operative and posto-perativematernal complicationsof CS during a ten year period Eur J. Obstet, Gynecol. Reprod. Biol 74(1) 1-6 1997.
[12]
Sloan NL, Amoaful EA, Winikoff P. Adjei S. Validity of women’s self-reported obstetric complications in rural Ghana. J Health PopulNutr 2001; 19(2): 45-51
[13]
Zurayk H, Khattab H, Younis N, ELMouelhy M, Fadle M. Concepts and measures of reproducted morbidity. Health Transit Rev. 1993; 3: 17-40
[14]
Hillian EM. Postoperative morbidity following caesarean delivery. J AdvNurs 1995; 22: 1035 – 42
[15]
Cepicky P, Stembera Z, Zeman V, Lomickova T, Mandys F. When is it possible to meet the wish of a woman to terminate her labour by caesarean section? Europ J obstetGynaecol 1990; 38; 109-112
[16]
Danso KA. Abdominal wound infection complicating caesarean section. GhanaMed J 1998, 32 b: 1003-9
[17]
Tran TS., Jamulitrat S; Chongsuvivatwong V. Greater A. Risk factors for post caesarean surgical site infection. Obstet and GynaecolVol 95, Number 3, March 2000, 367-371(5)
[18]
Brumffield CG, Hauth JC, Andrews WW. Puerperal Infection after cesarean delivery: evaluation of a standardized protocol. Am J ObstetGynecol 2000 May; 182(5): 1147-51
[19]
Noyes N, Berkelej AS, Freedman K. Incidence of postpartum endomyometritis following single dose antibiotic prophylaxis in high risk caesarean section patients. Infect Dis ObstetGynaecol 1998; 6(5):220-3.
Browse journals by subject