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Cape Town – More Caesarean sections need to be performed in African countries to gauge the benefits of the procedure.

This is according to researchers led by Professor Bruce Biccard, who found that C-sections were 50 times more deadly for African women.

The study was published in the Lancet Global Health journal.

It found that one in 200 women died during or soon after a C-section in a sampling of nearly 3 700 births across 22 African countries.

Biccard, from UCT’s Department of Anaesthesia and Perioperative Medicine, said the main reason for deaths was driven by peripartum haemorrhage and anaesthesia complications.

“There are not enough early identifications and access to surgery. The number of human resources is also low. There is a minimum number of experts needed for a safe C-section,and that is low. Women die predominantly through bleeding. We have a big network of investigators working on this and we are trying to look at addressing that problem next year.”

Biccard said there needed to be more C-sections performed to improve the outcomes.

“In high-income countries it is normal to have many antenatal check-ups, and problems can be identified early. Here in Africa we are below the threshold of C-sections performed, and we are not providing enough to see the benefits.

"Higher-income countries have surpassed the threshold, and in some cases, unnecessary C-sections are being performed. The recommendation is that they need to decrease the number of C-sections.”

Biccard said many of the C-sections performed in Africa were emergency ones, as a result of the lack of antenatal care afforded to women.

“Because issues are not identified early, the outcome becomes much worse. Babies can also be affected; babies that survive are at risk of getting cerebral palsy and they also stand to grow up without mothers.”

The study said mothers and their children were dying at unacceptable rates in Africa.

“Two-thirds of the global maternal deaths in 2015 occurred in sub-Saharan Africa, and the maternal mortality rate is estimated to be more than double the global average of 546 maternal deaths per 100 000 live births.

"The neonatal mortality rate is also highest in sub-Saharan Africa, at 28 per 1 000 live births, compared with the global average of 19 per 1000 live births.”

The study, by a self-initiated research grant from the South African Medical Research Council, saw 183 hospitals from 22 African countries participating.

They included the DRC, The Gambia, Madagascar, South Africa and Zimbabwe.

Data on more than 90% of operations was looked at.

“South Africa was part of the study and the findings are generalised. We don’t want to pick out a country as being better or worse. In general, the signal is across the continent,” Biccard said.

Cape Times