Planned Cesarean Section at Term (≥ 37 Weeks of Amenorrhea), Indications and Relevance at the Mali Bamako Hospital

Introduction: Planned full-term cesarean section is part of a set of priority targeted procedures due in particular to their frequency, the disparity of practices and a dynamic of increase. The decision on the mode of delivery (planned cesarean or natural delivery) is re-evaluated throughout the pregnancy depending on medical and obstetrical elements concerning the woman. The mode of delivery may ultimately be different from that initially planned. There has not been an evaluation of our indications for planned cesarean sections, hence the interest in initiating this work. Objective: Our aim was to determine the rate of planned cesarean section at term according to clinical practice recommendations. Methods and Materials: This was a descriptive, cross-sectional study with retrospective recruitment of files over a period of eighteen months, taking place from January 1, 2023 to June 30, 2024 in the obstetrics and gynecology department of the hospital. from Mali to Bamako. The target population was women seen in prenatal consultations during the study period. The inclusion criteria were all patients with an indication for planned cesarean section at our department during the study period. The non-inclusion criteria were indications for cesarean sections during labor in our department during the study period. Data entry and statistical analysis were carried out using SPSS software. The Pearson chi-square test as well as the Fisher exact test with a significance threshold of 5% (p ˂ 0.05) were used for the interpretation of the data. Results: Our cesarean section rate was 12.3% (n=64/520). The main indications were respectively multi-scarred uterus, diabetic macrosomia, scarred uterus + borderline pelvis, severe preeclampsia and pregnancy and immature pelvis with respectively 4%, 1.5%, 1.2%, 1.2% and 1.2%. At the end 12% (n=12/520) of primiparous women had undergone a cesarean section compared to 10% (n=52/520) of multiparous women. Conclusion: It is important to communicate internally with all professionals concerned for the decision-making of planned cesarean section, in order to choose the most appropriate mode of delivery while avoiding unjustified cesarean sections, thus reducing the number of scarred uteri linked to Cesarean section can cause multiple scarring of the uterus.