Cesarean delivery surveillance system at a maternity hospital in Kabul, Afghanistan

Int J Gynaecol Obstet. 2009 Jan;104(1):14-7. doi: 10.1016/j.ijgo.2008.08.024. Epub 2008 Oct 15.


Objective: To use an active facility-based maternal and newborn surveillance system to describe cesarean delivery practices and outcomes in a resource-poor setting.

Methods: Using data from operating room logbooks, 392 cesarean deliveries were evaluated between April 1 and June 30 2006 at a large public maternity hospital in Kabul, Afghanistan.

Results: The perinatal mortality rate was 89 per 1000 births: 57% antepartum and 37% intrapartum stillbirths. Fetuses with normal birth weight comprised 85% of intrapartum stillbirths. Obstructed labor, uterine rupture, and malpresentation accounted for more than 50% of perinatal deaths. The cesarean delivery rate was 10.2% and there were 2 maternal deaths.

Conclusion: The high percentage of intrapartum stillbirths among normal birth weight fetuses suggests a need for improved labor monitoring and surgical obstetric practices. The use of a facility-based perinatal surveillance system is critical in guiding such quality assurance initiatives.

MeSH terms

  • Afghanistan / epidemiology
  • Cesarean Section / statistics & numerical data*
  • Female
  • Hospitals, Maternity / statistics & numerical data
  • Humans
  • Medical Audit*
  • Obstetric Labor Complications / mortality*
  • Population Surveillance*
  • Pregnancy
  • Stillbirth / epidemiology*