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Accouchement : Taux élevé de césariennes dans les centres hospitaliers

Le taux des opérations césariennes est encore inquiétant par rapport aux recommandations de l’OMS. Elles seraient liées au non-respect des recommandations du médecin et de la pathologie maternelle

Le taux d’accouchement par césarienne est encore élevé dans le pays. Bien qu’il n’y ait pas encore de données sur l’opération césarienne au niveau national, le taux obtenu auprès de quelques centres hospitaliers dépasse largement les recommandations de l’Organisation mondiale de la santé (OMS). Elle ne devrait pas dépasser les 15% au niveau national pourtant celui du Centre hospitalier universitaire gynécologique obstétrique de Befelatanana (CHU GOB) est de 30%, idem également pour la maternité Pavillon Sainte Fleur. Pour le Centre hospitalier de Soavinandriana (CENHOSOA) ce taux peut même aller jusqu’à 50%. Selon le président du collège malgache des gynécologues obstétriciens, Pr Hery Rakotovao durant un atelier organisé à Anosy , cette opération doit être réservée à des indications médicales précises lorsque la grossesse risque de mettre en danger la santé de l’enfant ou de la mère. Toutefois, elle peut être soit programmée à l’avance durant la grossesse soit décidée en urgence durant l’accouchement.

L’abus de la pratique de cette opération césarienne engendre en effet une grossesse à risque ou pathologique . « Cette grossesse pathologique peut avoir plusieurs causes. Il pourrait s’agir d’une malformation congénitale ou encore d’une pathologie maternelle qui peuvent se traduire par l’apparition d’hypertension artérielle » a précisé le Pr Hery Rakotovao , directeur du CHU GOB de Befelatanana. Mais les grossesses précoces des jeunes filles de 16 à 17 ans ou encore les grossesses tardives après 45 ans en sont les plus exposées. A Madagascar , 25% des femmes soit une femme sur 5 en sont victimes. Les symptômes d’une grossesse à risque varient d’une personne à l’autre mais elle peut se manifester par des saignements vaginaux importants, des pertes de connaissance, de vives douleurs abdominales ou encore de violents maux de tête.

Hanitra Rakotobe

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