Maternal and Fetal Prognosis in Case of Emergency Cesarean Section at Cnhu-Hkm in Cotonou from 2021 to 2023

Introduction: Cesarean section is an artificial delivery procedure that allows fetal extraction after surgical opening of the uterus. Emergency cesarean sections are performed during pregnancy or delivery within a short timeframe for maternal and/or fetal rescue. The objective of this study was to examine the practice of emergency cesarean sections at the National University Hospital-Hubert Koutoukou Maga (CNHU-HKM) in Cotonou from 2021 to 2023. Materials and Methods: This is a retrospective, descriptive study over a three-year period from January 1, 2021 to December 31, 2023, including women who underwent emergency cesarean sections at the CNHU-HKM during this period and the newborns resulting from these cesarean sections. We worked on 1400 cases meeting these selection criteria. Results: Emergency cesarean sections accounted for 23.59% of deliveries. The mean time from decision to cesarean section was 114 minutes. The indications and mean times to cesarean section ranged from 158 minutes for placenta previa, 144 minutes for severe hypertension, and 138 minutes for eclampsia to 95 minutes for acute fetal distress, 58 minutes for pre-rupture syndrome, 49 minutes for acute pulmonary edema, and 22 minutes for prolapsed cord. The longer the time, the higher the maternal morbidity and mortality and neonatal mortality. Maternal mortality was 1.36%, with a decreasing trend over the years. Neonatal mortality was 11.53%. Conclusion: Emergency cesarean sections represent a significant proportion of all deliveries at CUGO due to its status as a referral center. The waiting time for emergency cesarean sections remains long for some indications. Reducing this waiting time is important to improve maternal and fetal outcomes. It is essential to establish good collaboration between the different stakeholders, obstetricians, anesthetists and midwives.