Revista Ciencias Biomédicas (Jan 2015)

CHARACTERIZATION OF THE MATERNAL AND NEONATAL ADVERSE OUTCOMES AFTER CAESAREAN SECTION IN THE CLÍNICA DE MATERNIDAD RAFAEL CALVO

  • Rubio-Hoyos Sandra M,
  • Méndez-Rodríguez Rogelio,
  • Contreras-Arrieta Sandra

Journal volume & issue
Vol. 6, no. 2
pp. 241 – 250

Abstract

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Introduction: the World Health Organization (WHO) recommends that the incidence of cesarean must not exceed 15%; however, its use has increased in the last two decades, which implies a public health problem. Objective: to characterize the maternal and neonatal adverse outcomes of caesarean in the Clínica Maternidad Rafael Calvo (CMRC),Cartagena-Colombia. Methodology: a descriptive cross-sectional study, where after cesarean maternal and neonatal adverse outcomes were characterized. Results: 1.804 cesarean sections (46.5%) and 2.073 vaginal deliveries (53.5%) were performed. The most common indications for cesarean section were before cesarean (35.5%), cephalo pelvic disproportion (30.6%) and oligoamnios (10.8%). The most common adverse maternal outcomes were bleeding requiring transfusion (9.17%), surgical wound hematoma (3.28%) and admission to ICU (1.5%). The most common adverse neonatal outcomes were APGAR <7 per minute (21.3%), transient tachypnea of the newborn (9.6%) and Apgar <7 at 5 ‘(4.3%). Prenatal care (PNC) was protective factor for uterine bleeding requiring transfusion (OR crude 0.54, CI 0.38 to 0.76, OR adjusted 0.53 IC 0.38 to 0.76), uterine bleeding which required hysterectomy (OR crude 0.20, CI 0.01 to 0.72, OR adjusted 0.11, IC: 0.11 to 0.72), obstetric shock (OR crude 0.06, IC: 0.00 to 0.55 ,OR adjusted 0.04, CI 0.04 to 0.38) and destination (rooming) (OR 0.66, IC 0.49 to 0.90), APGAR <7 at 1 ‘( OR 0.78 IC 0.44 to 0.72), Apgar <7 at 5 ‘(adjusted OR 0.48, IC 0.28 to 0.82) and the presence of respiratory distress (OR crude 0,28 IC, 0.15 to 0.51; OR adjusted 0.53, IC 0.28 to 0.98) Conclusions: the proportion of cesarean sections performed in the CMRC (46.5%) is above 15% recommended by WHO. Cesarean section leads to increased maternal and fetal morbidity. The CNP acted as a protective factor against the occurrence of adverse maternal and neonatal outcomes. Rev.cienc.biomed. 2015;6(2):241-250 KEYWORDS Cesarean; Obstetric; Hemorrhage.

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