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Caesarean delivery: An experience from a tertiary institution in north western Nigeria

Objective: To assess the overall caesarean section (CS) rate, indications and outcomes in a tertiary hospital in North-western Nigeria. Materials and Methods: A cross-sectional study carried out over a period of two years. All patients who had caesarean section at any time within the day were noted and followed up till discharge. The socio-demographic data, types of CS, anaesthesia, indications, abdominal wall and uterine incisions, cadre of surgeon and feto-maternal outcomes were documented in a proforma. Statistical analysis was carried out using the EPI INFO 3.5.1 (CDC Atlanta Georgia, USA). Result: The caesarean section rate was 11.3% (504/4462) of total deliveries. The highest rate of 44.6% (225/504) was among the primipara. The most common age group involved was 25 to 29 years. The emergency rate was 57.1% (288/504), while elective CS constituted 42.9% (216/504) of cases. The most common indication for emergency CS was obstructed labour 25.7% (30/288) and previous CS 39.8% (86/216) for elective CS. The complication rate was 13.3% (67/504) and the main complication was haemorrhage 59.7% (40/67). Complications were more with emergency CS compared to elective surgery (χ2 = 6.633, df = 1, P < 0.01) and with junior residents (χ2 = 15.9, df = 1, P < 0.001). There were 10 maternal and 60 perinatal deaths. Conclusions: The rate of caesarean section has been increasing gradually. There is need to improve on facilities and manpower in order to reduce morbidity and mortality.