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A Six-Year Review of Caesarean Sections at the Federal Teaching Hospital Abakaliki, Ebonyi State, South East Nigeria

Background: Globally, the rise in the rate of caesarean section 
is becoming a public health problem. This study examined the rate, indications 
and complications of caesarean section at the Federal Teaching Hospital 
Abakaliki (FETHA). Subjects and Methods: This was a six-year retrospective study covering January 1st 2012 to December 31st 2017. Patients who met the inclusion criteria 
were identified from the theatre records and their case notes retrieved from 
the health information unit of the hospital. Information extracted includes 
sociodemographic data, indications and types of caesarean section performed and 
the complications. Data was collected using a structured proforma and entered 
into a secured personal computer. Data analysis was performed by means of Epi Info version 7. Results are 
presented in tables, means and simple percentages. Results: During this 
period, a total of 11,215 deliveries were recorded at FETHA, of these, 3908 
were delivered by CS giving a caesarean section rate of 34.8%. The mean age of 
the study subjects was 29.3 ± 5.03 years. Almost half (49.7%) of the patients 
were in the 20 - 29 age group. Multiparous women made up 36.0% while 
nulliparous women were 12.6%. The most common 
indication for an emergency caesarean section was failure to progress in labour with 20.0% contribution and the most 
common indication for elective caesarean section was previous caesarean section with 13.5%. Majority of the babies were 
delivered at term (77.0%) with an average gestational age of 38 ± 2.6 weeks. 
Almost two-thirds of the subjects (62.5%) 
had emergency caesarean section. The 
average birthweight was 3.03 ± 0.71 kg. 
Maternal anaemia was the most common complication recorded 38.0%. There was direct maternal death in 2.0% of 
the study population. Severe birth asphyxia was recorded in 12.3% of the babies 
while there was 3.2% perinatal death. Conclusion: There is a high rate 
of caesarean section from this study. The 
World Health Organization has stated that there is no additional maternal or 
fetal benefit with caesarean section rate 
of greater than 10% - 15%. Stakeholders and policy 
makers need to do more to mitigate this rising trend.