Cesarean Maternal & Neonatal Mortality in Africa

Maternal mortality after cesarean delivery in Africa is 50 times higher than that of high-income countries and is driven by peripartum haemorrhage and anaesthesia complications. Neonatal mortality is double the global average.

These shocking figures from a prospective observational study across Africa may be due to such factors as poor access to caesarean delivery, peripartum hemorrhage, and provision of anesthesia by non-physicians.

Suggested areas to improve include risk identification (eg, ASA status, risk of bleeding), care bundles and checklists and a higher level of monitoring, use of antifibrinolytic drugs (tranexamic acid), improved access to blood and blood products with long shelf lives, such as freeze-dried plasma and fibrinogen; and novel methods of training of non-physician anaesthetists, including online support and mobile-based applications.

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