Elsevier

The Lancet

Volume 330, Issue 8559, 12 September 1987, Pages 612-613
The Lancet

Maternal Health
EMERGENCY OBSTETRIC SURGERY PERFORMED BY NURSES IN ZAIRE

https://doi.org/10.1016/S0140-6736(87)92996-5Get rights and content

Abstract

In rural northwestern Zaïre nurses at Karawa and Wasolo hospitals were trained to do caesarean sections, laparotomies, and supracervical hysterectomies. In Karawa 278 of 321 caesarean sections were done by nurse-surgeons in 18 months, with two deaths. In Wasolo all 32 caesarean sections in 13 months were done by the nurse-surgeons, with 1 death. Of the 37 laparotomies done in both centres, 16 were by nurse-surgeons, and there were two deaths. Four of the five deaths were attributable to protracted labour with septicaemia (1), postoperative infection (2), and protracted labour with no blood pressure on admission (1). Obstetric operations could safely be performed by specially trained nurses in rural areas of developing countries and the high maternal mortality rate in such areas could thus be reduced.

References (9)

  • A. Rosenfield et al.

    Maternal mortality—a neglected tragedy: Where is the M in MCH?

    Lancet

    (1985)
  • H. Mahler

    The safe motherhood initiative: a call to action

    Lancet

    (1987)
  • U. Hogberg

    Maternal mortality in Sweden

    (1985)
  • Em Nordberg

    Incidence and estimated need of caesarean section, inguinal hernia repair, and operation for strangulated hernia in rural Africa

    Br Med J

    (1984)
There are more references available in the full text version of this article.

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