Use of Cesarean Birth at Mizan Tepi University Teaching Hospital, Mizan Aman, Ethiopia.
Margo S Harrison, Tewodros Liyew, Ephrem Kirub and 4 others
PMID 33126047WHAT IT FOUND
At an Ethiopian teaching hospital, 23.4% of 993 women had cesarean birth, mostly for fetal or maternal indications.
Longer labor, incomplete partogram use, and transfer during labor were associated with cesarean, and cesarean was associated with postpartum antibiotics.
Key findings
01Cesarean birth occurred in 23.4% of the 993 women with delivery-mode data, with fetal indications accounting for 46.2% and maternal indications 35.9% of cesarean births; only 0.4% were elective.
02In nulliparous women with term, singleton, cephalic fetuses in spontaneous labor, cesarean birth was more likely with older age, labor longer than 24 hours, or partogram use that was incomplete or not applicable, and cesarean birth was associated with postpartum antibiotic administration.
03In multiparous women with term, singleton, cephalic fetuses in spontaneous labor, transfer during labor, labor longer than 12 hours, and partogram use marked not applicable were associated with primary cesarean birth, and cesarean birth was associated with maternal blood transfusion, postpartum antibiotics, neonatal antibiotics, and lower Apgar scores.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study could not determine whether each cesarean birth was medically indicated, so it shows where cesarean birth happened, not whether it should have happened. It was a convenience sample from one hospital, so the rates and associated factors may not apply elsewhere. Delivery-mode data were missing for 13 women (5.6%), and some variables, such as indication, were general. Women who delivered before 28 weeks were considered previable and not included, so preterm cesarean use may be underreported. The study reports associations, not proof that changing partogram use, labor duration, or transfer would reduce cesarean birth.
Declared interests
The authors declared no relationships or commercial associations that could influence the work, and said the findings represent their own views, not their institutions.
The easy way to misread this
Do not read the 23.4% cesarean rate as proof that cesarean birth was overused or that changing partogram use would prevent it. The study could not determine medical indication for each birth, and it reports associations in a single hospital rather than a tested intervention.