Previous Caesarean scar, malpresentation and malposition, antepartum hemorrhage, obstructed labor, cephalopelvic disproportion, non-reassuring fetal heart rate pattern, and multiple pregnancies are the most common indications of Caesarean section. ĭespite World Health Organization (WHO) recommended the optimal rate of Caesarean section should be lie between 5 and 15%, it is significantly increasing even if the reasons for the continued increase in the Caesarean rates are not completely understood: women are having fewer children, maternal age is rising, use of electronic fetal monitoring is widespread, malpresentation especially breech presentation, frequency of forceps and vacuum delivery is decreased, rate of labor induction increases, obesity dramatically rises and Vaginal birth after Caesarean decreased are some of the possible explanations. Maternal outcomes of Caesarean section included: postpartum fever, surgical site infection, puerperal sepsis, maternal mortality whereas neonatal sepsis, early neonatal death, stillbirth, perinatal asphyxia, low Apgar score, and prematurity were the most common complication of the newborn. ĭespite Caesarean section a life saving medical intervention and procedures to the decrease adverse birth outcome, controlling different postoperative neonatal and maternal complications are challenging in terms of patient safety, long duration of hospital stay, cost and psychological trauma. Īccording to American College of Obstetricians and Gynecologist (ACOG) report, Caesarean delivery significantly increased woman’s risk vulnerability of pregnancy-related morbidity and mortality which accounts (35.9 deaths per 100,000 live deliveries) as compared to a women posses vaginal delivery (9.2 deaths per 100,000 live births). The rate of Caesarean section is different across countries even between urban and rural areas, due to different socio-economic statuses, and opportunities to access public and private health care services. Caesarean section is the delivery of the fetus, membrane, and placenta through abdominal and uterine incision after fetal viability. Increasing unjustified Caesarean section deliveries as a way to increase different neonatal and maternal complications, then several interventions needed to target both the education of professionals and the public.Ĭaesarean section is the commonest operative delivery technique in the world. Cephalopelvic disproportion, low Apgar score, and febrile morbidity were the most common indication of Caesarean section, neonatal outcome and maternal morbidity following Caesarean section respectively. In this systematic review and meta-analysis, the rate of Cesarean section was high. The common neonatal complications following Caesarean section included low APGAR score, perinatal asphyxia, neonatal sepsis, meconium aspiration syndrome, early neonatal death, stillbirth, and prematurity whereas febrile morbidity, surgical site infection, maternal mortality, severe anemia, and postpartum hemorrhage were the most common maternal complications following Caesarean section. Cephalopelvic disproportion was the most common indication of Caesarean section followed by non-reassuring fetal heart rate pattern. Caesarean section is associated with both maternal and neonatal complications. The overall pooled prevalence of Caesarean section was 29.55% (95% CI: 25.46–33.65). The pooled prevalence of the caesarean section, indications, and outcomes was calculated using the random-effect model. All the included papers were extracted and appraised using the standard extraction sheet format and Joanna Briggs Institute respectively. Online databases (PubMed/Medline, Hinari, Web of Science, and Google Scholar) and online university repository was used. Twenty three cross-sectional studies with a total population of 36,705 were included. Therefore this systematic review and meta-analysis aimed to estimate the prevalence, indication, and outcomes of caesarean section in Ethiopia. However, it has both maternal and neonatal adverse outcomes. Caesarean section is an essential maternal healthcare service. Caesarean section rates have increased worldwide in recent decades.
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