ABSTRACT
OBJECTIVE: To determine Ghanaian women's preferred mode of delivery and opinion of caesarean section after caesarean delivery. DESIGN: A cross sectional study of women who recently delivered by caesarean section prior to hospital discharge. SETTING: Two teaching hospitals in Ghana: Komfo Anokye Teaching Hospital, Kumasi, and Korle-Bu Teaching Hospital, Accra. RESPONDENTS: 154 patients who delivered by caesarean section between the 1(st) and 31(st) August, 2003 were interviewed. Of the 154 initiating the interview, 151 completed, and 145 had complete data. MAIN OUTCOME MEASURES: Delivery preference and general opinion of caesarean delivery. RESULTS: The majority of women interviewed indicated that they preferred vaginal delivery (55%). Despite preference for vaginal delivery among these women who had delivered by caesarean section, the majority had a generally positive opinion of caesarean section (53%). CONCLUSION: Ghanaian women with experience of caesarean delivery prefer vaginal delivery.
ABSTRACT
SUMMARY OBJECTIVES: The main objectives of this study were to determine the incidence, maternal characteristics, indications, the maternal and perinatal outcomes and the complications of emergency peripartum hysterectomies done at the Korle-Bu Teaching Hospital. STUDY DESIGN: This is a retrospective descriptive study covering the period January 1, 2000 to June 30, 2003. SETTING: Maternity Unit of the Korle-Bu Teaching Hospital RESULTS: The incidence of peripartum hysterectomy during the study period was 4.34/1000 deliveries. The main indication was severe uterine bleeding from uterine rupture 89 (48.9%), uterine atony 60 (33%), placenta accreta 20 (11%) and post caesarean uterine wound sepsis and necrosis 11 (6%). The average blood loss was 2.02 (SD 0.86) L and all patients received blood transfusion. The mean age of the patients was 31.6 (SD 5.3) years and the mean parity was 2.7 (SD 1.7). Complications occurred in 28 (19.8%) patients. The stillbirth rate was 483.5/1000 deliveries and the maternal mortality was 12.9%. The average duration of hospital stay was 11 (SD 8) days. CONCLUSIONS: The incidence of emergency peripartum hysterectomy is high. It is performed for young nulliparous women through to elderly grand-multiparous women. The surgery is associated with significant maternal and perinatal morbidity and mortality. Timely expert management in a well resourced centre is advocated.