A retrospective study of matched symphysiotomies and caesarian sections at Port Moresby General Hospital

The caesarian section rate at Port Moresby General Hospital (PMGH) is 26.7/1000 and the symphysiotomy rate 2.5/1000 deliveries respectively. 40% of the caesarian sections are for cephalopelvic disproportion and in 50% of these cases the diagnosis is made late in labour; it is this group that is compared with the symphysiotomy group. The morbidities of each group are similar, 64% and 62% respectively. The maternal mortality rate in the caesarian section group was 11.6/1000 and the perinatal mortality 160/1000. There were no maternal deaths in the symphysiotomy group and the perinatal mortality rate was 82/1000. It is recommended that symphysiotomy should be more widely accepted as a safe alternative to caesarian section from both the maternal and foetal point of view.