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Caesarean sections in rural Burundi: how well are mothers doing two years on?

2016; International Union Against Tuberculosis and Lung Disease; Volume: 6; Issue: 2 Linguagem: Inglês

10.5588/pha.15.0075

2220-8372

Wilma van den Boogaard, Marcel Manzi, Eva De Plecker, Séverine Caluwaerts, Kassi Nanan-N’Zeth, B. Duchenne, William Etienne, N. Juma, B. Ndelema, Rony Zachariah,

Sex work and related issues

Setting: A caesarean section (C-section) is a life-saving emergency intervention.Avoiding pregnancies for at least 24 months after a C-section is important to prevent uterine rupture and maternal death.Objectives: Two years following an emergency C-section, in rural Burundi, we assessed complications and maternal death during the post-natal period, uptake and compliance with family planning, subsequent pregnancies and their maternal and neonatal outcomes.Methods: A household survey among women who underwent C-sections.Results: Of 156 women who underwent a C-section, 116 (74%) were traced; 1 had died of cholera, 8 had migrated and 31 were untraceable.Of the 116 traced, there were no post-operative complications and no deaths.At hospital discharge, 83 (72%) women accepted family planning.At 24 months after hospital discharge (n = 116), 23 (20%) had delivered and 17 (15%) were pregnant.Of the remaining 76 women, 48 (63%) were not on family planning.The main reasons for this were religion or husband's non-agreement.Of the 23 women who delivered, there was one uterine rupture, no maternal deaths and three stillbirths.Conclusions: Despite encouraging maternal outcomes, this study raises concerns around the effectiveness of current approaches to promote and sustain family planning for a minimum of 24 months following a C-section.Innovative ways of promoting family planning in this vulnerable group are urgently needed.