Maternal and Fetal Outcome in Cesarean Section in Three Referral Hospital in Yaoundé: Elective Versus Emergency. What are the Places of the Type of Anaesthesia and the Experience of the Surgeon?

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Introduction. Caesarean section (CS) represents the most common and one of the most important operation in obstetrics. Its incidence is on the rise worldwide. Despite the improvement in the technique of CS and anesthesia, adverse maternal and fetal outcomes remain high. We therefore carried out this study to evaluate the places of surgeon and anesthesia in maternal and fetal outcomes of Emergency CS in Yaounde. Material and methods. We carried out a prospective cohort study from the 1 st of November 2016 to the 30 th May 2017 in three referral hospitals in Yaounde. Data collected were entered using Epi info 7.2.0.1 and analyzed with Epi info and SPSS 20.0 using a confidence interval (CI) of 95%. Two-tailed p-values < 0.05 was considered statistically significant. The RR was used to assess the degree of association between studied variables. Results. The mean age was 31.91± 5.15 in the emergency CS group and 26.56 ± 6.08 in the elective CS group. Women who were administered general anesthesia were significantly at least 2 times at risk of hemorrhagic complications, still birth and birth asphyxia than spinal anesthesia (p value = 0.04). Complications occurred more frequently in cases operated by residents than those operated by obstetricians but there was no significantly statistic difference. (p value = 0.16). Conclusion. General anaesthesia is more associated with poor maternal and fetal adverse than spinal anesthesia. Maternal and fetal outcome is not associated to the experience of the surgeon. We therefore recommended to promote the spinal anesthesia technique for CS.

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