[Postoperative complications and free caesarean section in Mali = case of a health district]

Our study aimed to assess the impact of free caesarean section on emergency obstetric care. This was a descriptive cross-sectional study that took place over a period of eight months during the period of June 1^st, 2007 to January 31^th, 2008. The study included 262 parturients admitted from August 1^st, 2004 to July 31^th, 2006. Among the 262 parturients 43.13% were recorded before and 56.87% after the implementation of the free of charge caesarean. Caesarean section was performed in 46.90% of parturients before and at 60.40% after the implementation of the free of charge caesarean. The age group 20 to 35 years was the most represented with 58.40%. Complications were present in 37.74% of women delivered by cesarean section before the implementation of the free of charge caesarean and in 20% after its implementation. The infection was seen in 70% of women delivered by cesarean section before the implementation of the free of charge caesarean and 61.11% after its implementation. Among deaths, 5.66% were recorded before and 1.11% after the implementation of the free of charge caesarean. The heavy bleeding was seen in 37.50% cases. Stillbirths recorded before the implementation of the free of charge caesarean were 62.83% and after its implementation, they were of 20.13%. In 18.81% of stillbirths were associated with fetopelvic disproportion.

The implementation of the free of charge cesarean helped increase the frequency caesarean section and the reduction of stillbirth in the health district of San.