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

Tharani Kandasamy, Mario Merialdi, Richard J. Guidotti, Ana P. Betrán, Jennifer Harris-Requejo, Farima Hakimi, Paul F. Van Look, F. Kakar

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)14-17
Number of pages4
JournalInternational Journal of Gynecology and Obstetrics
Issue number1
StatePublished - Jan 2009
Externally publishedYes


  • Afghanistan
  • Birth weight
  • Cesarean delivery
  • Perinatal outcome
  • Quality assurance
  • Surveillance system

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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