Research

Maternal and fetal outcomes following delivery in a tertiary hospital in Johannesburg, South Africa

D F Guidozzi, S Branch, L Chauke

Abstract


Background. Caesarean section (CS) rates are rising worldwide. There is growing concern regarding the possible negative impacts on maternal and fetal health.

Objective. To assess birth outcomes of CS v. normal vaginal deliveries (NVD) using the Robson 10-group classification system at a tertiary hospital in Gauteng Province, South Africa. Primary postpartum haemorrhage (PPH), neonatal Apgar scores, neonatal intensive care unit admissions and perinatal deaths were recorded.

Methods. A retrospective review of all deliveries for neonates ≥500 g during September and October 2016 was undertaken. A total of 1 443 deliveries were assessed. The data were analysed using Statistical Package for the Social Sciences version 23.

Results. There were 730 (50.6%) CSs and 713 (49.4%) NVDs. The greatest contributor to the CS rate was group 5 (15.8%). PPH occurred in 8.3% of women delivered by CS, with an odds ratio (OR) of 1.86 (95% confidence interval (CI) 1.194 - 2.900). Additionally, three hysterectomies were performed in the CS group. A significant difference in Apgar scores was found only at 1 minute, with higher scores in the NVD group (CS mean (standard deviation) 7.74 (2.25), and NVD 8.10 (2.11); p=0.002). Eighty-nine (11.6%) neonates delivered by CS required high care admission, with an OR 1.865 (95% CI 1.292 - 2.692) for neonates delivered by CS.

Conclusion. The CS rate was 50.6%. Performing a CS should be weighed against the risks of the procedure. Although an understanding of some influences on the rate can be obtained, further research into indications, and protocol generation to optimise this rate, are needed to limit maternal and neonatal birth complications.


Authors' affiliations

D F Guidozzi, Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa

S Branch, Specialist in Obstetrics and Gynaecology at Morningside Hospital, Johannesburg, South Africa

L Chauke, Clinical Head of Department of Obstetrics and Gynaecology at Charlotte Maxeke Johannesburg Academic Hospital, South Africa

Full Text

PDF (130KB)

Keywords

Robson classification, caesarean section rate, South Africa

Cite this article

South African Journal of Obstetrics and Gynaecology 2018;24(3):74-78. DOI:10.7196/sajog.1396

Article History

Date submitted: 2018-10-05
Date published: 2019-06-14

Article Views

Abstract views: 28739
Full text views: 870

Comments on this article

*Read our policy for posting comments here


The South African Medical Association is the official publisher of the SAJOG.

                                                           

                                        SOUTH AFRICAN MEDICAL ASSOCIATION

                                                         Events | Careers | CPD

 

The South African Journal of Obstetrics and Gynaecology| Online ISSN: 2305-8862 | Print ISSN: 0038-2329 | 

Creative Commons Attribution - NonCommercial Works License (CC BY-NC 4.0) | 

This journal is protected by a Creative Commons Attribution - NonCommercial Works License (CC BY-NC 4.0) | Read our privacy policy.

SAMA Journals: South African Medical Journal African Journal of Health Professions Education South African Journal of Bioethics and Law South African Journal of Child Health | Southern African Journal of Critical Care  | South African Journal of Obstetrics and Gynaecology | Undergraduate Research in Health African Journal of Thoracic and Critical Care Medicine  | Southern African Journal of Public Health