Abstract

Setting: Benue State University Teaching Hospital, Makurdi is a new tertiary health care institution which was established by an Act of the Benue State House of Assembly and started offering clinical services in 2012. Background: There is widespread concern about the increasing proportion of births by caesarean section (CS) all over the world. Objectives: This study is to determine the CS rate, the indications, the trend and possible reasons for the rate in a new and emerging tertiary hospital. Patients and methods: The obstetric and theatre records of all caesarean deliveries that occurred at Benue State University Teaching Hospital, Makurdi, North Central Nigeria, between 1st September, 2002 and 31st August, 2014 were reviewed retrospectively. The total number of deliveries was obtained from labour ward. Results: There were 636 deliveries, out of which 124 were caesarean sections, giving a CS rate of 19.3%. Majority of the patients (43.5%) who had CS were in the age group 26-30 years, with (82.3%) of the total patients included in this study were in the age range of 21-35 years, with a mean of 28.8. Of those who had CS (124), 8.9% were nulliparous while 78.2% were multiparous. 67.4% of the women were booked, while 14.7% were unbooked. Most of the patients (75.9%) delivered at term (37-42 weeks gestation), 17.9% delivered preterm and 6.3% had prolonged pregnancy. Cephalopelvic disproportion (CPD) was the commonest indication for CS (28.8%), followed by previous CS and fetal distress (14.4% and 12.3% respectively). Conclusion: although the CS rate in the developed countries appears to have stabilized and is slowing down, that in developing countries is still high. The CS rate at BSUTH is very high. CPD was the singular most common factor responsible

Highlights

  • Caesarean section (CS) is one of the commonly performed surgical procedures in obstetrics and is certainly one of the oldest operations in surgery [1]

  • Patients and methods: The obstetric and theatre records of all caesarean deliveries that occurred at Benue State University Teaching Hospital, Makurdi, North Central Nigeria, between 1st September, 2002 and 31st August, 2014 were reviewed retrospectively

  • Majority of the patients (43.5%) who had CS were in the age group 26-30 years, with (82.3%) of the total patients included in this study were in the age range of 21-35 years, with a mean of 28.8

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Summary

Introduction

Caesarean section (CS) is one of the commonly performed surgical procedures in obstetrics and is certainly one of the oldest operations in surgery [1]. Studies evaluating the association CS rates with neonatal death have shown outcome improvements up to a CS rate of 10% [7,8,9]. Several studies have shown an association between CS rate and maternal and infant mortality at population level in low income countries where large sectors of the population lack access to basic obstetric care [7,8,10]. The CS rate above a certain limit have not shown additional benefit for the mother or the baby, and some studies have even shown that high CS rates could be linked to negative consequences in maternal and child health [7,8,9,10,11]. There is widespread concern about the increasing proportion of births by caesarean section (CS) all over the world

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