Mortality related to caesarean section in rural Matebeleland North Province, Zimbabwe

Abstract

Maternal mortality ratio in low income countries is 100-500 times higher than in rich countries; compare the extremes: Zimbabwe with 1100 maternal deaths/100 000 live births and Sweden with 2/100 000.' Mortality rates related to caesarean section (CS) are in the same range, 0.5-2% (1:2001:50) in poor income countries and 0.01-0.02% (1:10 000-1:5 000)2 in the richer parts of the world. Mortality is greater in women who have more than one CS compared to those with a first CS, because of increasing age and therefore hi gher prevalence of general medical conditions, as well higher incidence of complications such as ruptured uterus (risk 0.2-1.5% after low transverse incision) and placenta praevia or accreta (risks 1.1-3.0 and 5-10 times greater than in an unscarred uterus).2 Compared to vaginal birth maternal mortality related to CS was shown to be 17 times higher in a medical audit in Midlands province in Zimbabwe.