Complications After Caesarean Section in Rwanda
Paulin Banguti, Eugene Tuyishime, Brigitte Kalala, jShefali Hegde, Jessica Amick, & Marcel Durieux
Women in sub-Saharan Africa face a disproportionate risk of severe injury or death in childbirth compared to Western countries. In 2016, Rwanda’s maternal mortality rate (MMR) stood at 320 deaths per 100,000 live births. Government investment in education and health infrastructure has allowed for an astonishing decreasing trend in maternal death. However, high rates of Cesarean section (CS) place undue stress on the health system, expose patients to unnecessary surgical risks, and predispose women to subsequent delivery complications.
In an attempt to better understand the modifying effect of CS on immediate health outcomes, anesthesiologists at the Centre Hospitalier de Kigali (CHUK) designed a comprehensive project to measure CS complications. We analyzed a sample of 340 patient charts who were admitted in CHUK to identify the age, referral hospital, reason for cesarean section and other demographic factors relating to morbidity and mortality of mothers and infants.
We found peritonitis and sepsis to be the most common complications in mothers post-CS. We found no significant relationship between geographic distance from the hospital and mortality and between type of delivery and mortality.
Inclusion criteria for our study excluded those who did not survive the travel from the district hospital and CHUK, which limited our results. Future research groups should collect data from a larger population set and explore the feasibility of data collection directly from the district hospitals. We obtained comprehensive information on CS rates from the main referral hospitals, which can be used to develop protocols to limit unnecessary CS, as well as to address the surprisingly high rates of peritonitis and sepsis.