Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry

Sow Alhassane II; Diallo Fatoumata Bamba; Diallo Ibrahima Tangaly; Balde Abdoulaye Djibril; Balde Boubacar Talibe; Diallo Laouratou; Keita Moustapha; Diallo Abdourahamane; Balde Ibrahima Sory; Sy Telly

doi:doi:10.11648/j.jgo.20251301.12

Research Article |

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Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry

Sow Alhassane II^*

, Diallo Fatoumata Bamba

, Diallo Ibrahima Tangaly

, Balde Abdoulaye Djibril, Balde Boubacar Talibe, Diallo Laouratou, Keita Moustapha, Diallo Abdourahamane, Balde Ibrahima Sory, Sy Telly

Published in Journal of Gynecology and Obstetrics (Volume 13, Issue 1)

Received: 25 January 2025 Accepted: 8 February 2025 Published: 24 February 2025

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Abstract

Introduction: Surgical interventions are essential in certain situations requiring the pregnant woman to be spared the complications of pregnancy or dystocic delivery. The aim of this work was to identify factors associated with post-cesarean maternal complications. Methodology: This was a 6-month prospective analytical study, from June 1 ^toDecember 31, 2022, carried out in the gynecology-obstetrics department of the Ignace Deen National Hospital of the Conakry University Hospital, involving pregnant and parturient women undergoing cesarean section in the department during the data collection period who had or had not had postoperative complications and agreed to participate in the study. Results: The frequency of post-cesarean complications was 8.31%. The mean age of the patients was 26.7±5.93 years. The 25-34 age group was the most represented (49.4%). They were mainly housewives (41.3%), married (95.7%), not in school (43.0%) and evacuated (41.8%). Emergency cesarean section was the most commonly performed (69.0%). Anemia (53.5%), surgical site infection (26.8%) and postpartum hemorrhage (16.9%) were the most frequently recorded complications with a case fatality rate of 0.7%. Factors likely to be associated with the occurrence of post-cesarean complications were obstetric evacuation (OR=2.151; CI: 1.312-3.527), multiparity (OR=3.544; CI: 2.009-6.252), absence of PNC (OR=21.702; CI: 11.012-42.769), prenatal follow-up in health centers (OR=3.027; CI: 1.597-5.737), emergency cesarean (OR=2.619; CI: 1.353-5.067), qualification of the prenatal follow-up agent (OR=7.317; CI: 2.698-19.842) and prolonged labor (OR=2.057; CI: 1.261-3.353). Conclusion: The elements likely to influence the occurrence of postoperative complications were obstetric evacuation, multiparity, absence of prenatal consultation, prenatal monitoring in health centers, emergency cesarean section, qualification of the prenatal monitoring agent (health technical agent) and prolonged labor. Raising awareness of the importance of prenatal monitoring, performing prophylactic cesareans in the event of any absolute indication for cesarean section, limiting births, and good monitoring of the immediate postpartum period could reduce the risk of post-cesarean complications.

Published in	Journal of Gynecology and Obstetrics (Volume 13, Issue 1)
DOI	10.11648/j.jgo.20251301.12
Page(s)	9-16
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Associated Factors, Cesarean Complications, Ignace Deen, Guinea

1. Introduction

Interventions are essential in certain situations requiring the pregnant woman to be spared the complications of pregnancy or dystocic delivery. Caesarean section is a surgical procedure that consists of performing an artificial delivery after surgical opening of the uterus, generally approached by abdominal route, exceptionally by vaginal route

[1]

. It is one of the oldest and most frequently performed surgical procedures on women in the world

[2, 3]

. However, Caesarean section presents risks of infection 5 to 20 times compared to vaginal delivery

[4-6]

. Despite scientific progress recorded in all fields, Caesarean section is still not a harmless procedure. Indeed, it can be peppered with complications which include, among others, anemia, urinary tract infection, endometritis, thrombophlebitis, pelvic peritonitis, surgical site infections with an increase in the average length of hospitalization from 2 to 7 days

[7]

. In developed countries, frequencies of post-cesarean complications of 5.7% and 21.5% have been reported in the literature

[8, 9]

. In Africa in sub- Saharan Africa, post-cesarean complication rates remain high, ranging between 7.06% and 37.74% according to several authors

[10-13]

. With post-cesarean maternal mortality rates of 0.92%, 2.8% and 7.6% reported in Mali, Guinea and Gabon respectively

[11, 14, 15]

. Unfavorable socioeconomic conditions, obstetric evacuations, prolonged labor, premature rupture of membranes, metrorrhagia, the urgent nature of the cesarean section and its long duration of performance are risk factors for post-cesarean complications reported in the literature

[10]

. Reducing maternal morbidity and mortality related to cesarean section requires early identification of contributing factors in these patients. It is in this context that this work is carried out, the objective of which was to identify the factors associated with maternal post-cesarean complications.

2. Methodology

2.1. Type and Duration of Study

This was a 6-month prospective analytical study, from June 1 todecember 31, 2022, carried out in the gynecology-obstetrics department of the Ignace Deen National Hospital of the Conakry University Hospital.

2.2. Study Population

The study focused on pregnant and parturient women undergoing cesarean sections in the department during the data collection period who had or had not had post-operative complications and agreed to participate in the study.

The diagnosis of postoperative complication was made on the basis of clinical and paraclinical elements from the daily examination of the patients and biological assessments carried out when necessary to confirm the presumptive diagnosis.

2.3. Sampling

We conducted a non-probability sampling of pregnant and parturient women undergoing cesarean section in the department and meeting the inclusion criteria defined above. The patients were divided into two groups:

Group 1: it consisted of women who underwent caesarean surgery and had post-operative complications during their stay in the department;

Group 2: it included women who had undergone cesarean surgery and who did not develop any post-operative complications.

2.4. Data Collection

Data were collected through the review of prenatal consultation records (PNC), obstetric evacuation forms, the interview of pregnant/parturient women on admission, their clinical examination during hospitalization to look for a postoperative complication and the interpretation of the results of the biological examination.

2.5. Variables

The variables studied were: sociodemographic (age, occupation, level of education and marital status), obstetric (parity, number of prenatal consultations, structure for carrying out prenatal consultations, qualification of the health worker who offered the prenatal consultations, state of the water bag as well as the duration of rupture of the water bag, the duration of labor, the type of cesarean section and the type of complications) and prognostic, evaluated according to the occurrence or not of maternal death at hospital discharge.

2.6. Data Entry and Analysis

The data were entered using Excel software from the Office 2016 package and analyzed using SPSS.26.0 software. The data analysis allowed us to calculate the odds ratio with a 95% confidence interval around it. The significance threshold was 5%, i.e. a p-value less than 0.05.

2.7. Ethical Considerations

Informed consent was obtained from participants, confidentiality and anonymity were maintained. The results obtained will be used only for scientific purposes.

2.8. Difficulties

The difficulties encountered were the very short hospital stay (average duration of 3 days) due to the limited number of places and the influx of obstetric evacuations in the department, because since 2005, it has been the only operational level III maternity hospital for the entire city of Conakry and its surrounding prefectures.

3. Results

3.1. Frequency and Sociodemographic Characteristics

During the study, 854 patients were included in this work including 71 cases of post-cesarean complications or 8.31%. The average age of the women was 26.7±5.93 years with extremes of 14 and 47 years. They were mainly housewives (41.3%), married (95.7%) and not in school (43.0%). (Table 1).

3.2. Obstetric Parameters

Obstetric evacuation was the most frequent mode of admission (41.8%), pauciparous women represented 50.6% of the sample, 38.4% of caesareans had not had any prenatal consultation. In 65.0% of cases, prenatal consultations were carried out by midwives. Emergency caesarean section was the most common (69.0%). Nearly 3 out of 10 women (27.9%) had ruptured their water bags before admission and the duration of labor was less than 24 hours in 62.6% of cases. (Table 2).

The most frequently recorded complications were anemia (53.5%), surgical site infection (26.8%) and postpartum hemorrhage (16.9%). (Table 3).

The postoperative maternal lethality rate was 0.7%.

3.3. Factors Associated with the Occurrence of Post-cesarean Complications

After the analysis, we find certain factors likely to be associated with the occurrence of post-cesarean complications. These are obstetric evacuation (OR=2.151; CI: 1.312-3.527), multiparity (OR=3.544; CI: 2.009-6.252), absence of CPN (OR=3.498; CI: 2.094-5.843), performance of prenatal monitoring in health centers (OR=3.316; CI: 1.440-7.635), emergency cesarean section (OR=2.619; CI: 1.353-5.067), qualification of the prenatal monitoring agent (OR=8.854; CI: 2.236-35.060) and prolonged labor (OR=2.057; CI: 1.261-3.353). (Table 4).

Table 1. Sociodemographic characteristics of patients.

Sociodemographic characteristics	Staff	Percentage
Age groups (year)
≤ 18	57	6.7
19-24	271	31.7
25-34	422	49.4
≥ 35	104	12.2
Average age: 26.7±5.93 years
Occupation
Housewife	353	41.3
Student	157	18.4
Liberal	281	32.9
Employee	63	7.4
Marital status
Bride	817	95.7
Bachelor	37	4.3
Level of education
Not in school	367	43.0
Primary	176	20.6
Secondary	227	26.6
University	84	9.8

Table 2. Obstetric characteristics of patients who underwent cesarean section.

Obstetric parameters	Staff	Percentage
Admission mode
Evacuated	357	41.8
Coming by herself	497	58.2
Parity
Primiparous	324	37.9
Pauciparous	432	50.6
Multiparous	98	11.5
Number of PNC
0	42	4.9
1-3	772	90.4
≥ 4	40	4.7
PNC implementation structure (n=812)
Health center	273	33.6
MMC	206	25.4
UHC	156	19.2
Private Structure	177	21.8
Qualification of the agent who carried out the PNC (n=812)
Doctor	274	33.7
Midwife	517	63.7
Health technical agent	21	2.6
Type of cesarean section
Prophylactic	265	31.0
Emergency	589	69.0
State of the water pocket
Intact	615	72.0
Broken	239	28.0
Duration of water rupture
Less than 24 hours	156	18.3
Greater than 24 hours	83	9.7
Intact	615	72.0
Duration of labor
Less than 24 hours	535	62.6
Greater than 24 hours	319	37.4

PNC: prenatal consultation; MMC: municipal medical center; UHC: university hospital center.

Table 3. Types of complications presented by patients.

Types of complications	Staff (n=71)	Percentage
Endometritis	6	8.4
Postpartum hemorrhage	12	16.9
Urinary tract infection	3	4.2
Acute intestinal obstruction	1	1.4
Anemia	38	53.5
Surgical site infection	19	26.8
Thrombophlebitis	1	1.4
Eclamptic coma	3	4.2

3.4. Maternal Lethality

During the study period, we recorded 6 cases of postoperative maternal deaths out of 854 cesarean sections performed, i.e. a case fatality rate of 0.7%. These were mainly deaths occurring in cases of severe decompensated anemia, hemorrhagic shock and eclamptic coma.

Table 4. Distribution of patients according to factors likely to be associated with the occurrence of post-cesarean complications.

Settings	Complications n =71		Without complications n =783		OR; CI: 95%	P-value
	n	%	n	%
Age groups
≤ 18	5	7.04	52	6.6	1,065[0,411-2,758]	0.896
19-24	26	36.62	245	31.3	1,268[0,765-2,104]	0.353
25-34	34	47.89	388	49.6	0.935[0.575-1.521]	0.788
≥ 35	6	8.45	98	12.5	0.645[0.272-1.528]	0.315
Occupation
Housewife	30	42.2	323	41.3	1,042[0,637-1,704]	0.869
Student	19	26.8	138	17.6	1,707[0,978-2,979]	0.057
Liberal	16	22.5	265	33.8	0.568[0.319-1.011]	0.052
Employee	6	8.5	57	7.3	1,175[0,488-2,830]	0.717
Admission mode
Evacuated	42	59.2	315	40.2	2,151[1,312-3,527]	0.001
Coming by herself	29	40.8	468	59.8
Level of education
Not in school	38	53.5	329	42.0	1,589[0.975-2.587]	0.060
Primary	11	15.5	165	21.1	0.686[0.353-1.335]	0.265
Secondary	15	21.1	212	27.1	0.721[0.399-1.303]	0.277
University	7	9.9	77	9.8	1.002[0.443-2.265]	0.994
Parity
Primiparous	18	25.3	306	39.1	0.529[0.304-0.920]	0.022
Pauciparous	33	46.5	399	51.0	0.835[0.513-1.360]	0.469
Multiparous	20	28.2	78	9.9	3,544[2,009-6,252]	0.000
Number of PNC
0	24	33.8	18	2.3	21,702[11,012-42,769]	0.000
1-3	43	60.6	729	93.1	0.113[0.065-0.197]	0.000
≥ 4	4	5.6	36	4.6	1,238[0,428-3,585]	0.692
PNC implementation structure
Health center	24	51.1	249	32.5	3,027[1,597-5,737]	0.000
MMC	10	21.3	196	25.6	0.784[0.383-1.607]	0.506
UHC	8	17.0	148	19.3	0.855[0.391-1.868]	0.694
Private structure	5	10.6	172	22.5	0.410[0.159-1.053]	0.056
Qualification of the agent who carried out the PNC						0.031
Doctor	18	38.3	256	33.5	1,234[0,672-2,264]	0.496
Midwife	23	48.9	494	64.6	0.525[0.291-0.949]	0.030
Health technical agent	6	12.8	15	1.9	7,317[2,698-19,842]	0.000
Type of cesarean section						0.393
Emergency	60	84.5	529	67.6	2,619[1,353-5,067]	0.003
Prophylactic	11	15.5	254	32.4
State of the water pocket
Intact	52	73.2	563	71.9	1,150[0.659-2.008]	0.621
Broken	19	26.8	220	28.1	0.869[0.498-1.516]
Water break time
Less than 24 hours	12	16.9	144	18.4	0.910[0.476-1.737]	0.775
Greater than 24 hours	7	9.9	76	9.7	1,017[0,450-2,299]	0.966
Intact	52	73.2	563	71.9	1.062[0.614-1.838]	0.827
Duration of labor
Greater than 24 hours	38	60.3	281	37.4	2,547[1,505-4,310]	0.000
Less than 24 hours	25	39.7	471	62.6

PNC: prenatal consultation; MMC: municipal medical center; UHC: university hospital center; OR: odds ratio; CI: confidence interval.

4. Discussion

In this work, we attempted to identify the factors associated with post-cesarean maternal complications in the obstetrics-gynecology department of the Ignace Deen National Hospital over a period of 6 months. This work showed a frequency of post- cesarean complications of 8.31%. Anemia (53.5%), surgical site infection (26.8%) and postpartum hemorrhage (16.9%) were the most common complications. Factors likely to contribute to the occurrence of post-cesarean complications were obstetric evacuation, multiparity, failure to perform prenatal consultation, emergency cesarean section and prolonged labor.

In this series, we recorded a frequency of post-cesarean maternal complications of 8.31%. Tshimbundu Kayembe A et al.

[16]

reported in their work on maternal post-cesarean complications in the DRC a frequency of 22.47%. A post-cesarean complication rate of 27% was recorded in Finland in 2010

[17]

But this result is higher than that reported in the same department 14 years ago (2008) by Baldé IS et al.

[18]

or 7%. This disparity could be explained by the fact that since the closure of the maternity ward of the Donka national hospital in 2015 for the renovation of this hospital, the maternity ward of Ignace Deen has seen its activities doubled or even tripled from 3000 to 8000 deliveries per year and constitutes the only level III reference structure ensuring the management of the majority of obstetric emergencies coming from secondary and tertiary structures of the city of Conakry and its surroundings, thus increasing the cesarean rate as well as the risks of postoperative complications.

Anemia was the most frequently encountered postoperative complication in this series. An observation identical to ours was made in 2018 at the Gabriel Touré University Hospital in Bamako by Dembélé DD

[19]

. This observation could be explained by malnutrition, multiparity and closely spaced pregnancies responsible for chronic anemia on the one hand and on the other hand the occurrence of hemorrhages in per partum (retroplacental hematoma and placenta previa), during cesarean section and in the immediate postpartum period. This calls on all health workers involved in maternal health to ensure early detection and adequate management of anemia during pregnancy and strict monitoring of women in labor in the immediate postpartum period.

Surgical site infection was the most common post-cesarean infectious complication in this study. This frequency of post-operative infectious complications could be underestimated because of their somewhat late onset and the short stay of patients in the department, the average of which is 3 days, due to the influx of obstetric emergencies and the limited number of places. A predominance of surgical site infection in post-cesarean complications was reported by some authors

[18, 20]

. We agree with the conclusion of Tshimbundu Kayembe A et al.

[16]

who reported in their series a frequency of surgical site infection of 26.82%, ranking second among post-cesarean complications.

This work shows that evacuated patients were more exposed to the occurrence of post-cesarean complications compared to those who came from home. This finding is consistent with those of Dembelé DD et al.

[18]

and Baldé IS et al.

[19]

who found a statistically significant link between obstetric evacuation and the occurrence of post-cesarean complications. In the majority of cases, these were parturients evacuated from secondary structures where there were several hours or even days of unsuccessful attempts at vaginal delivery during which a problem arose, thus worsening the maternal prognosis.

The finding reveals that multiparous women were at greater risk of postoperative complications compared to other patients. An identical observation was reported by Tshimbundu Kayembe A in the DRC in 2024

[16]

DRC. Our finding is consistent with that of Tallé B et al. who found in their series a statistically significant link between the occurrence of post-cesarean complications and grand multiparity. Multiparity exposes parturients to postpartum complications (postpartum hemorrhage) because of the high risk of uterine atony in this group of parturients. For some authors, parity alone cannot be considered a risk factor for the occurrence of postoperative complications; it is the combination of several factors, namely age, obstetric evacuation and socioeconomic level

[19]

In this series, it appears that parturients undergoing emergency cesarean sections were more exposed to the occurrence of postoperative complications compared to those undergoing prophylactic cesarean sections. An observation identical to ours was reported by Alemu et al. in Ethiopia mentioning that obstetric emergencies exposed to the occurrence of postoperative complications by almost 3 times

[21]

. This could be explained by the fact that emergency cesarean sections are most often performed on women in labor for several hours, or even days, evacuated from level 2 structures sometimes with their waters broken. Cesarean sections performed in this context could increase the risk of postoperative complications.

This work reveals that women who did not have prenatal consultations were more likely to have post-cesarean morbidity compared to other pregnant women. A statistically significant link between the absence of prenatal consultation and post-cesarean complications was reported by some authors

[22, 23]

. This result could be explained by the fact that the failure to carry out prenatal monitoring can lead to the absence of detection and management of certain maternal morbidities of pregnancy (anemia, pre-eclampsia, urinary tract infection, etc.) which could persist or even worsen in the postpartum period, thus increasing maternal morbidity and mortality rates.

Parturients with prolonged labor were more likely to have postoperative complications compared to other groups of parturients. Diallo MH et al.

[24]

reported in their work on cesarean section complications, a statistically significant association between prolonged labor and the occurrence of postcesarean complications.

Compared to maternal lethality, it was 0.7% in this series. Higher post-cesarean lethality rates have been reported by some authors in Guinea and Senegal, varying between 1.25% and 3.45%

[24-26]

. This difference could be explained by the introduction of free obstetric and neonatal care and the improvement of the conditions for performing cesareans in our structure by the introduction of locoregional anesthesia and access to resuscitation facilities.

Conclusion: This work shows a significant frequency of post-cesarean complications. Anaemia, surgical site infection and postpartum haemorrhage were the most frequent complications. Factors likely to influence the occurrence of post-operative complications were obstetric evacuation, multiparity, absence of prenatal consultation, prenatal monitoring in health centres, emergency cesarean section, qualification of the prenatal monitoring provider (health technical agent) and prolonged labour.

Raising awareness of the importance of prenatal monitoring, performing prophylactic cesareans in the event of any absolute indication for cesarean section, limiting births, and good postpartum monitoring could reduce the risk of post-cesarean complications.

Abbreviations

CI	Confidence Interval
MMC	Municipal Medical Center
OR	Odds Ratio
PNC	Prenatal Consultation
UHC	University Hospital Center

Author Contributions

Sow AII (design, data collection and analysis, and manuscript writing), Diallo FB (manuscript review), Diallo IT (Surgery), Baldé AD (surgery), Baldé BT (data collection), Diallo L (data collection), Keita M (data collection), Diallo A (manuscript revision), Baldé IS (manuscript revision), Sy T (manuscript revision).

Conflicts of Interest

The authors declare no conflict of interest related to this work.

References

[1]	Merger R, Levy J, Melchior J. Obstétrique et pathologies gynécologiques. Précis d'obstétrique 6ème édition; Masson, Paris. 2001: 533-542.
[2]	Rothec, Schlaich C, Thompson S. Infections associées aux soins de santé en Afrique subsaharienne. J Hosp Infect. 2013; 85(4): 257- 67. https://doi.org/10.1016/j.jhin.2013.09.008
[3]	Mpogoro FJ, Mshana SE, Mirambo MM, Kidenga BR, Gomodoko B, Imirzalioglu C. Incidence et facteurs prédictifs des infections du site chirurgical après une césarienne au centre médical de Bugando, en Tanzanie. Antimicrob Resist Infect Control. 2014; 3: 25. https://doi.org/10.1186/2047-2994-3-25
[4]	Hadiati DR, Hahimi M, Nurdiati DS. Préparation cutanée pour prévenir l'infection après une césarienne. Cochrane. Database Syst Rev. 2018; 10(10): CD007462. https://doi.org/10.1002/14651858.CD007462.pub4
[5]	Conroy K, Koenig AF, Yu Y, Courtney A, Lee HJ, Morwitz ER. Morbidité infectieuse après césarienne: 10 stratégies pour réduire le risque. Rev obstet Gynecol. 2012; 5(2): 69-77.
[6]	Lyimo FM, Massinde AM, Kidenya BR, Konfe E, Mshana SE. Efficacité d'une dose unique de gentamicine en association avec le métronidazole par rapport à des doses multiples pour la prévention de l'infection post - césarienne. Protocole d'étude pour un essai contrôlé randomisé. Essais. 2012; 13: 89. https://doi.org/10.1186/1471-2393-13-123
[7]	Barbut F, Cabonne B, Truchot F, Spielvogel C, Jannet D, Goderel I et al. Infection du site opératoire chez les patientes césarisées: bilan de 5 ans de surveillance. J Gynecol Obstet Biol Reprod (Paris). 2004; 33(6): 87-96. https://doi.org/10.1016/s0368-2315(04)96561-1
[8]	Renate MI, Häger E, Daltveit KA, et al. Complications de la césarienne: taux et facteurs de risque. Am J Obstet Gynecol. 2004; 190(2): 428-34. https://doi.org/10.1016/j.ajog.2003.08.037
[9]	Jennifer L. Le registre des césariennes du MFMU: impact de l'heure de la journée sur les complications de la césarienne. American Journal of Obstetrics and Gynecology. 2006; 95: 132-7. https://doi.org/10.1016/j.ajog.2006.06.009
[10]	Sylla Y, Coulibaly O, Camara D, Keita M, Diarra I, Diarra S et coll. Complications maternelles des césariennes au centre de santé de référence de la commune I du district de Bamako. Health Sci. Dis. 2023; 24(10): 92-96. https://doi.org/10.5281/hsd.v24i10.4872
[11]	Diawara A, Sangho H, Tangara I, Cissé MO, Traoré MN et Konaté S. complications post césarienne et gratuite de la césarienne au Mali: cas d'un centre de santé de district. Mali Med. 2014; 29(1): 45-49.
[12]	Sylla C, Traoré SO, Traoré A, Samaké A, Doumbia S et coll. Pronostic materno-fœtal de la césarienne prophylactique versus césarienne d'urgence au centre de sante de référence de la commune V du district de Bamako. Sciences de la santé. Dis. 2020; 21(12): 79-85. https://doi.org/10.5281/hsd.v21i12.2389
[13]	Kemfang Ngowa JD, Ngassam A, Tsuala Fouogue J, Metogo J, Medou A, Kasia JM. Complications maternelles précoces de la césarienne: à propos de 460 cas dans deux hôpitaux universitaires de Yaoundé, Cameroun. PAMJ. 2015; 21: 265. https://doi.org/10.11604/pamj.2015.21.265.6967
[14]	Balde IS, Balde O, Diallo FB, Sylla I, Sow AII, et al. Morbidité et mortalité maternelles postopératoires après césarienne et laparotomie pour rupture utérine au service de gynécologie et d'obstétrique de l'hôpital national Ignace Deen en Guinée. J Reprod Med Gynecol Obstet. 2021; 6: 073. https://doi.org/10.24966/RMGO-2574/100073
[15]	Tchantchou TDD, Ngou Mve Ngou JP, Lembet Mikolo AM, Bang JA, Sima Ole B, Minko JI et coll. Pronostic materno-foetal de la césarienne en urgence à l'hôpital d'instruction des armées Omar Bongo Ondimba. RECAC. 2018; 3(14): 19-24.
[16]	Tshibundu Kayembe A, Mulumba Kapuku S. Complications maternelles postopératoires d'une césarienne: une étude transversale à l'Hôpital Général Provincial de Kananga en République Démocratique du Congo. PAMJ. 2024; 47(23). 2-10. https://doi.org/10.11604/pamj.2024.47.23.40458
[17]	Pallasmaa N, Ekblad U, Aitokallio-Tallberg A, Uotila J, Raudaskoski T, Ulander VM et coll. Césarienne en Finlande: complications maternelles et facteurs de risque obstétricaux. Acta Obstetricia et Gynecologica. 2010; 89: 896-902. https://doi.org/10.3109/00016349.2010.487893
[18]	Baldé IS, Sy T, Diallo MC, Diallo Y, Soumah FM, Diallo A, Sissoko S, Diallo FB, Diallo MS. Complications maternelles post césarienne au service de Gynécologie-Obstétrique de l'hôpital national Ignace Deen (CHU de Conakry). Anales de la SOGGO. 2008; 11(3): 170-175.
[19]	Dembélé DD. Etude des complications de la césarienne dans le service de Gynécologie-obstétrique du CHU Gabriel Touré de Bamako. Thèse de Doctorat en Médecine. 2018(238): 62-66.
[20]	Benkirane S, Saadi H, Mimouni A. Le profil épidémiologique des complications maternelles de la césarienne au CHR EL Farabi Oujda. Journal médical panafricain. 2017; 27: 108. https://doi.org/10.11604/pamj.2017.27.108.10036
[21]	Alemu H, Yigzaw ZA, Asrade L, Nega B et Belachew A. Proportion et facteurs associés de complications maternelles des césariennes chez les mères qui accouchent dans les hôpitaux publics spécialisés de la ville de Bahir Dar, Bahir Dar, Éthiopie. BMC Women's Health. 2023; 23: 237. https://doi.org/10.1186/s12905-023-02388-y
[22]	Samaké BM, Traoré Y, Niani M, Keita B, Keita M, Togola M et coll. Facteurs de morbi-mortalité de la césarienne au centre hospitalier universitaire Gabriel touré de Bamako. Mali médical. 2017; 32(2): 14-18.
[23]	Negese K et Belachew DZ. Complications maternelles et facteurs associés chez les mères ayant subi une césarienne à l'hôpital général de Gebretsadik Shewa: une étude transversale institutionnelle. Front. Glob. Santé des femmes. 2023; 4: 1091863. https://doi.org/10.3389/fgwh.2023.1091863
[24]	Diallo MH, Baldé IS, Diallo AD, Baldé O, Diallo BS, Sylla I et coll. Complications maternelles de la césarienne dans un pays à ressources limitées: cas de la maternité de l'hôpital régional de Kankan, Guinée. Revue ouverte d'obstétrique et de gynécologie. 2019; 9: 981-990. https://doi.org/10.4236/ojog.2019.97095
[25]	Diallo FB, Diallo MS, Bangoura S, Diallo AB et Camara Y. Césarienne: un facteur de réduction de la morbidité et de la mortalité foeto-maternelle à l'hôpital universitaire Ignace Deen de Conakry, Guinée. Médecine d'Afrique Noire. 1998; 45: 359-364.
[26]	Cissé CT, Andriamady C, Faye O, Diouf A, Bouillin D et Diadhiou F. Indications et pronostic de la césarienne au CHU de Dakar. Revue de gynécologie-obstétrique et biologie de la reproduction. 1995; 24: 194-197.

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APA Style

II, S. A., Bamba, D. F., Tangaly, D. I., Djibril, B. A., Talibe, B. B., et al. (2025). Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry. Journal of Gynecology and Obstetrics, 13(1), 9-16. https://doi.org/10.11648/j.jgo.20251301.12

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II, S. A.; Bamba, D. F.; Tangaly, D. I.; Djibril, B. A.; Talibe, B. B., et al. Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry. J. Gynecol. Obstet. 2025, 13(1), 9-16. doi: 10.11648/j.jgo.20251301.12

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AMA Style

II SA, Bamba DF, Tangaly DI, Djibril BA, Talibe BB, et al. Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry. J Gynecol Obstet. 2025;13(1):9-16. doi: 10.11648/j.jgo.20251301.12

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@article{10.11648/j.jgo.20251301.12,
  author = {Sow Alhassane II and Diallo Fatoumata Bamba and Diallo Ibrahima Tangaly and Balde Abdoulaye Djibril and Balde Boubacar Talibe and Diallo Laouratou and Keita Moustapha and Diallo Abdourahamane and Balde Ibrahima Sory and Sy Telly},
  title = {Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry
},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {13},
  number = {1},
  pages = {9-16},
  doi = {10.11648/j.jgo.20251301.12},
  url = {https://doi.org/10.11648/j.jgo.20251301.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20251301.12},
  abstract = {Introduction: Surgical interventions are essential in certain situations requiring the pregnant woman to be spared the complications of pregnancy or dystocic delivery. The aim of this work was to identify factors associated with post-cesarean maternal complications. Methodology: This was a 6-month prospective analytical study, from June 1 to December 31, 2022, carried out in the gynecology-obstetrics department of the Ignace Deen National Hospital of the Conakry University Hospital, involving pregnant and parturient women undergoing cesarean section in the department during the data collection period who had or had not had postoperative complications and agreed to participate in the study. Results: The frequency of post-cesarean complications was 8.31%. The mean age of the patients was 26.7±5.93 years. The 25-34 age group was the most represented (49.4%). They were mainly housewives (41.3%), married (95.7%), not in school (43.0%) and evacuated (41.8%). Emergency cesarean section was the most commonly performed (69.0%). Anemia (53.5%), surgical site infection (26.8%) and postpartum hemorrhage (16.9%) were the most frequently recorded complications with a case fatality rate of 0.7%. Factors likely to be associated with the occurrence of post-cesarean complications were obstetric evacuation (OR=2.151; CI: 1.312-3.527), multiparity (OR=3.544; CI: 2.009-6.252), absence of PNC (OR=21.702; CI: 11.012-42.769), prenatal follow-up in health centers (OR=3.027; CI: 1.597-5.737), emergency cesarean (OR=2.619; CI: 1.353-5.067), qualification of the prenatal follow-up agent (OR=7.317; CI: 2.698-19.842) and prolonged labor (OR=2.057; CI: 1.261-3.353). Conclusion: The elements likely to influence the occurrence of postoperative complications were obstetric evacuation, multiparity, absence of prenatal consultation, prenatal monitoring in health centers, emergency cesarean section, qualification of the prenatal monitoring agent (health technical agent) and prolonged labor. Raising awareness of the importance of prenatal monitoring, performing prophylactic cesareans in the event of any absolute indication for cesarean section, limiting births, and good monitoring of the immediate postpartum period could reduce the risk of post-cesarean complications.
},
 year = {2025}
}

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TY  - JOUR
T1  - Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry

AU  - Sow Alhassane II
AU  - Diallo Fatoumata Bamba
AU  - Diallo Ibrahima Tangaly
AU  - Balde Abdoulaye Djibril
AU  - Balde Boubacar Talibe
AU  - Diallo Laouratou
AU  - Keita Moustapha
AU  - Diallo Abdourahamane
AU  - Balde Ibrahima Sory
AU  - Sy Telly
Y1  - 2025/02/24
PY  - 2025
N1  - https://doi.org/10.11648/j.jgo.20251301.12
DO  - 10.11648/j.jgo.20251301.12
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 9
EP  - 16
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20251301.12
AB  - Introduction: Surgical interventions are essential in certain situations requiring the pregnant woman to be spared the complications of pregnancy or dystocic delivery. The aim of this work was to identify factors associated with post-cesarean maternal complications. Methodology: This was a 6-month prospective analytical study, from June 1 to December 31, 2022, carried out in the gynecology-obstetrics department of the Ignace Deen National Hospital of the Conakry University Hospital, involving pregnant and parturient women undergoing cesarean section in the department during the data collection period who had or had not had postoperative complications and agreed to participate in the study. Results: The frequency of post-cesarean complications was 8.31%. The mean age of the patients was 26.7±5.93 years. The 25-34 age group was the most represented (49.4%). They were mainly housewives (41.3%), married (95.7%), not in school (43.0%) and evacuated (41.8%). Emergency cesarean section was the most commonly performed (69.0%). Anemia (53.5%), surgical site infection (26.8%) and postpartum hemorrhage (16.9%) were the most frequently recorded complications with a case fatality rate of 0.7%. Factors likely to be associated with the occurrence of post-cesarean complications were obstetric evacuation (OR=2.151; CI: 1.312-3.527), multiparity (OR=3.544; CI: 2.009-6.252), absence of PNC (OR=21.702; CI: 11.012-42.769), prenatal follow-up in health centers (OR=3.027; CI: 1.597-5.737), emergency cesarean (OR=2.619; CI: 1.353-5.067), qualification of the prenatal follow-up agent (OR=7.317; CI: 2.698-19.842) and prolonged labor (OR=2.057; CI: 1.261-3.353). Conclusion: The elements likely to influence the occurrence of postoperative complications were obstetric evacuation, multiparity, absence of prenatal consultation, prenatal monitoring in health centers, emergency cesarean section, qualification of the prenatal monitoring agent (health technical agent) and prolonged labor. Raising awareness of the importance of prenatal monitoring, performing prophylactic cesareans in the event of any absolute indication for cesarean section, limiting births, and good monitoring of the immediate postpartum period could reduce the risk of post-cesarean complications.

VL  - 13
IS  - 1
ER  -

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Author Information

Sow Alhassane II

Department of Gynecology-Obstetrics, Ignace Deen National Hospital, Conakry University Hospital, Conakry, Guinea

Contact Email

http://orcid.org/0009-0000-3983-9047
Diallo Fatoumata Bamba

Gynecology-Obstetrics Department, Donka National Hospital, Conakry University Hospital, Conakry, Guinea

http://orcid.org/0009-0005-5679-8378
Diallo Ibrahima Tangaly

Gynecology-Obstetrics Department, Flamboyants Communal Medical Center, Conakry, Guinea

http://orcid.org/0009-0004-0630-3106
Balde Abdoulaye Djibril

Department of Gynecology-Obstetrics, Ignace Deen National Hospital, Conakry University Hospital, Conakry, Guinea
Balde Boubacar Talibe

Department of Gynecology-Obstetrics, Ignace Deen National Hospital, Conakry University Hospital, Conakry, Guinea
Diallo Laouratou

Department of Gynecology-Obstetrics, Ignace Deen National Hospital, Conakry University Hospital, Conakry, Guinea
Keita Moustapha

Department of Gynecology-Obstetrics, Ignace Deen National Hospital, Conakry University Hospital, Conakry, Guinea
Diallo Abdourahamane

Department of Gynecology-Obstetrics, Ignace Deen National Hospital, Conakry University Hospital, Conakry, Guinea
Balde Ibrahima Sory

Department of Gynecology-Obstetrics, Ignace Deen National Hospital, Conakry University Hospital, Conakry, Guinea
Sy Telly

Department of Gynecology-Obstetrics, Ignace Deen National Hospital, Conakry University Hospital, Conakry, Guinea

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Plain Text BibTeX RIS

APA Style

II, S. A., Bamba, D. F., Tangaly, D. I., Djibril, B. A., Talibe, B. B., et al. (2025). Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry. Journal of Gynecology and Obstetrics, 13(1), 9-16. https://doi.org/10.11648/j.jgo.20251301.12

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ACS Style

II, S. A.; Bamba, D. F.; Tangaly, D. I.; Djibril, B. A.; Talibe, B. B., et al. Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry. J. Gynecol. Obstet. 2025, 13(1), 9-16. doi: 10.11648/j.jgo.20251301.12

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AMA Style

II SA, Bamba DF, Tangaly DI, Djibril BA, Talibe BB, et al. Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry. J Gynecol Obstet. 2025;13(1):9-16. doi: 10.11648/j.jgo.20251301.12

Copy | Download

@article{10.11648/j.jgo.20251301.12,
  author = {Sow Alhassane II and Diallo Fatoumata Bamba and Diallo Ibrahima Tangaly and Balde Abdoulaye Djibril and Balde Boubacar Talibe and Diallo Laouratou and Keita Moustapha and Diallo Abdourahamane and Balde Ibrahima Sory and Sy Telly},
  title = {Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry
},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {13},
  number = {1},
  pages = {9-16},
  doi = {10.11648/j.jgo.20251301.12},
  url = {https://doi.org/10.11648/j.jgo.20251301.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20251301.12},
  abstract = {Introduction: Surgical interventions are essential in certain situations requiring the pregnant woman to be spared the complications of pregnancy or dystocic delivery. The aim of this work was to identify factors associated with post-cesarean maternal complications. Methodology: This was a 6-month prospective analytical study, from June 1 to December 31, 2022, carried out in the gynecology-obstetrics department of the Ignace Deen National Hospital of the Conakry University Hospital, involving pregnant and parturient women undergoing cesarean section in the department during the data collection period who had or had not had postoperative complications and agreed to participate in the study. Results: The frequency of post-cesarean complications was 8.31%. The mean age of the patients was 26.7±5.93 years. The 25-34 age group was the most represented (49.4%). They were mainly housewives (41.3%), married (95.7%), not in school (43.0%) and evacuated (41.8%). Emergency cesarean section was the most commonly performed (69.0%). Anemia (53.5%), surgical site infection (26.8%) and postpartum hemorrhage (16.9%) were the most frequently recorded complications with a case fatality rate of 0.7%. Factors likely to be associated with the occurrence of post-cesarean complications were obstetric evacuation (OR=2.151; CI: 1.312-3.527), multiparity (OR=3.544; CI: 2.009-6.252), absence of PNC (OR=21.702; CI: 11.012-42.769), prenatal follow-up in health centers (OR=3.027; CI: 1.597-5.737), emergency cesarean (OR=2.619; CI: 1.353-5.067), qualification of the prenatal follow-up agent (OR=7.317; CI: 2.698-19.842) and prolonged labor (OR=2.057; CI: 1.261-3.353). Conclusion: The elements likely to influence the occurrence of postoperative complications were obstetric evacuation, multiparity, absence of prenatal consultation, prenatal monitoring in health centers, emergency cesarean section, qualification of the prenatal monitoring agent (health technical agent) and prolonged labor. Raising awareness of the importance of prenatal monitoring, performing prophylactic cesareans in the event of any absolute indication for cesarean section, limiting births, and good monitoring of the immediate postpartum period could reduce the risk of post-cesarean complications.
},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - Factors Associated with Post-cesarean Maternal Complications in the Gynecology-Obstetrics Department of the Ignace Deen National Hospital CHU in Conakry

AU  - Sow Alhassane II
AU  - Diallo Fatoumata Bamba
AU  - Diallo Ibrahima Tangaly
AU  - Balde Abdoulaye Djibril
AU  - Balde Boubacar Talibe
AU  - Diallo Laouratou
AU  - Keita Moustapha
AU  - Diallo Abdourahamane
AU  - Balde Ibrahima Sory
AU  - Sy Telly
Y1  - 2025/02/24
PY  - 2025
N1  - https://doi.org/10.11648/j.jgo.20251301.12
DO  - 10.11648/j.jgo.20251301.12
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 9
EP  - 16
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20251301.12
AB  - Introduction: Surgical interventions are essential in certain situations requiring the pregnant woman to be spared the complications of pregnancy or dystocic delivery. The aim of this work was to identify factors associated with post-cesarean maternal complications. Methodology: This was a 6-month prospective analytical study, from June 1 to December 31, 2022, carried out in the gynecology-obstetrics department of the Ignace Deen National Hospital of the Conakry University Hospital, involving pregnant and parturient women undergoing cesarean section in the department during the data collection period who had or had not had postoperative complications and agreed to participate in the study. Results: The frequency of post-cesarean complications was 8.31%. The mean age of the patients was 26.7±5.93 years. The 25-34 age group was the most represented (49.4%). They were mainly housewives (41.3%), married (95.7%), not in school (43.0%) and evacuated (41.8%). Emergency cesarean section was the most commonly performed (69.0%). Anemia (53.5%), surgical site infection (26.8%) and postpartum hemorrhage (16.9%) were the most frequently recorded complications with a case fatality rate of 0.7%. Factors likely to be associated with the occurrence of post-cesarean complications were obstetric evacuation (OR=2.151; CI: 1.312-3.527), multiparity (OR=3.544; CI: 2.009-6.252), absence of PNC (OR=21.702; CI: 11.012-42.769), prenatal follow-up in health centers (OR=3.027; CI: 1.597-5.737), emergency cesarean (OR=2.619; CI: 1.353-5.067), qualification of the prenatal follow-up agent (OR=7.317; CI: 2.698-19.842) and prolonged labor (OR=2.057; CI: 1.261-3.353). Conclusion: The elements likely to influence the occurrence of postoperative complications were obstetric evacuation, multiparity, absence of prenatal consultation, prenatal monitoring in health centers, emergency cesarean section, qualification of the prenatal monitoring agent (health technical agent) and prolonged labor. Raising awareness of the importance of prenatal monitoring, performing prophylactic cesareans in the event of any absolute indication for cesarean section, limiting births, and good monitoring of the immediate postpartum period could reduce the risk of post-cesarean complications.

VL  - 13
IS  - 1
ER  -

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