{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:23:47Z","timestamp":1786368227209,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T00:00:00Z","timestamp":1590710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To analyze the indications for cesarean deliveries and factors associated with adverse perinatal outcomes in Sierra Leone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between October 2016 and May 2017, patients undergoing cesarean delivery performed by medical doctors and associate clinicians in nine hospitals were included in a prospective observational study. Data were collected perioperatively, at discharge, and during home visits after 30\u00a0days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 1274 cesarean deliveries were included of which 1099 (86.3%) were performed as emergency surgery. Of the 1376 babies, 261 (19.0%) were perinatal deaths (53 antepartum stillbirths, 155 intrapartum stillbirths, and 53 early neonatal deaths). Indications with the highest perinatal mortality were uterine rupture (45 of 55 [81.8%]), abruptio placentae (61 of 85 [71.8%]), and antepartum hemorrhage (8 of 15 [53.3%]). In the group with cesarean deliveries performed for obstructed and prolonged labor, a partograph was filled out for 212 of 425 (49.9%). However, when completed, babies had 1.81\u2010fold reduced odds for perinatal death (95% confidence interval 1.03\u20133.18, <jats:italic>P<\/jats:italic>\u2010value 0.041).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cesarean deliveries in Sierra Leone are associated with an exceptionally high perinatal mortality rate of 190 per 1000 births. Late presentation in the facilities and lack of adequate fetal monitoring may be contributing factors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13172","type":"journal-article","created":{"date-parts":[[2020,4,19]],"date-time":"2020-04-19T19:15:00Z","timestamp":1587323700000},"page":"213-221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Perinatal outcomes of cesarean deliveries in Sierra Leone: A prospective multicenter observational study"],"prefix":"10.1002","volume":"150","author":[{"given":"Alex J.","family":"van Duinen","sequence":"first","affiliation":[{"name":"Institute of Clinical and Molecular Medicine Norwegian University of Science and Technology  Trondheim Norway"},{"name":"Department of Surgery St. Olavs Hospital HF Trondheim University Hospital  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josien","family":"Westendorp","sequence":"additional","affiliation":[{"name":"Institute of Clinical and Molecular Medicine Norwegian University of Science and Technology  Trondheim Norway"},{"name":"University Medical Centre Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Kamara","sequence":"additional","affiliation":[{"name":"Ministry of Health and Sanitation  Freetown Sierra Leone"},{"name":"College of Medicine and Allied Health Sciences University of Sierra Leone  Freetown Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatu","family":"Forna","sequence":"additional","affiliation":[{"name":"World Health Organization  Freetown Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Hagander","sequence":"additional","affiliation":[{"name":"Surgery and Public Health Department of Clinical Sciences Lund Faculty of Medicine Skane University Hospital Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus J.","family":"Rijken","sequence":"additional","affiliation":[{"name":"University Medical Centre Utrecht  Utrecht The Netherlands"},{"name":"The Julius Centre for Health Sciences and Primary Care  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.M.","family":"Leather","sequence":"additional","affiliation":[{"name":"King's Centre for Global Health and Health Partnerships King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne","family":"Wibe","sequence":"additional","affiliation":[{"name":"Institute of Clinical and Molecular Medicine Norwegian University of Science and Technology  Trondheim Norway"},{"name":"Department of Surgery St. Olavs Hospital HF Trondheim University Hospital  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e5kon A.","family":"Bolkan","sequence":"additional","affiliation":[{"name":"Institute of Clinical and Molecular Medicine Norwegian University of Science and Technology  Trondheim Norway"},{"name":"Department of Surgery St. Olavs Hospital HF Trondheim University Hospital  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60496-7"},{"key":"e_1_2_9_3_1","unstructured":"The World Bank Group.World Bank Open Data[World Bank website].2019.https:\/\/data.world\u200bbank.org. 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