Caesarean Section at the Rivers State University Teaching Hospital, Southern Nigeria: A Five-year Review

Abstract

This chapter was aimed at reviewing CS at the Rivers State University Teaching Hospital (RSUTH), to determine the prevalence, trend and indications, for improved management outcomes. In this cross-sectional analysis, we looked at 5,598 caesarean sections (3699 emergencies, 1899 scheduled) performed at the RSUTH between January 1, 2015 and December 31, 2019. IBM, Statistical Product and Service Solutions (SPSS), version 25.0 Armonk, New York, was used to analyse the data. Over the review period, there were 13,516 deliveries and 5,598 cases of CS, resulting in a prevalence of 41.4 percent or 414 per 1000 deliveries. 66.1 percent and 33.9 percent of CS cases were emergency and scheduled, respectively. Over the review period, there was an upward trend in CS. The mean age ± SD of the participants was 32.30±1.04 years (95% CI:30.26,34.34). The modal age group was 35-39 years, accounting for 33.2% followed by those aged 30-34 years (26.2%). Majority of the patients were multipara [3396 (60.7%)], married [4890 (87.4%)], Christians [5540 (99%)] and had tertiary level education [2800 (50%)]. The commonest indication for CS in RSUTH was previous caesarean section [1925(34%)], followed by cephalopelvic disproportion [757(13.4%], foetal distress [418(7.4%)], preeclampsia [390(6.9%)] and multiple gestation [252 (4.5%)]. RSUTH has a high rate of caesarean sections, which is on the rise. Despite the fact that CS saves lives, efforts should be undertaken to reduce the rate to the WHO-recommended level, particularly in low- and middle-income countries (LMICs) where CS is disliked.