Cesarean section in Ahmadu Bello University Teaching Hospital Zaria, Nigeria: A five-year appraisal

Adelaiye, SM; Olusanya, AO; Onwuhafua, PI

doi:10.4103/tjog.tjog_58_16

Cited by 6 publications

(15 citation statements)

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“…There was one (1) maternal death giving a caesarean maternal mortality rate of 960/100,000. This is higher than the 908.6/100,000 live births [24] , 870/100,000 live births [30] and 646 per 100,000 live births [18] reported by other researchers but lower than 4654.8 per 100,000 live birth reported by John et al [27] . The only maternal death was neglected prolonged obstructed labour with intrauterine fetal death and chorioamnionitis.…”

Section: Discussioncontrasting

confidence: 57%

Caesarean delivery and the attendant FETO-maternal aftermath at a rural hospital in South Southern Nigeria

Alabrah¹,

Abasi²,

Ozori³

2022

Int. J. Clin. Obstet. Gynaecol.

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Background: Caesarean delivery is a necessary tool in the management of obstetric patients when indicated. However, there is general apprehension about the increasing proportion of births by caesarean section (CS) across the globe. Objectives: To ascertain the CS rate (CSR), the indications and the outcomes of caesarean delivery in the hospital. Methodology: The obstetric and theatre records of all caesarean deliveries at Federal Medical Centre Yenagoa, Otuoke outreach, South-South Nigeria, between January 2017 and December 2021 were assessed retrospectively. Generated data were analyzed using SPSS version 23. Results: There were 770 deliveries, out of which 104 were caesarean deliveries, giving a CSR of 13.5%. The majority, 71 (68.3%) of the patients had emergency caesarean delivery while 33 (31.7%) had an elective caesarean delivery. The commonest indication for caesarean delivery was cephalopelvic disproportion (CPD) (27.9%) followed by previous CS and breech in primigravida (17.3% and 7.7% respectively). The majority of the patients, 58 (55.8%) were booked while 46 (44.2%) were unbooked. The commonest morbidity encountered was anaemia which complicated 21.1% of cases. There was one maternal death and six perinatal deaths giving maternal and perinatal mortality rates of 960/100,000 and 49/1000 respectively. Conclusion:The caesarean section rate was within the limits laid down by the World Health Organization. CPD was the chief indication for CS followed by repeat CS and breech in primigravida. Efforts to maintain the CS rate, within acceptable limits, as noted in this study, should be continued.

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Section: Discussioncontrasting

confidence: 57%

Caesarean delivery and the attendant FETO-maternal aftermath at a rural hospital in South Southern Nigeria

Alabrah¹,

Abasi²,

Ozori³

2022

Int. J. Clin. Obstet. Gynaecol.

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“…12,13,18,21 Previous caesarean section was however the most common indication for caesarean section in Enugu, Nnewi, Zaria, and Shagamu. 14,15,19,24 Beyond the most common, and just as it was found in studies done in Port Harcourt, Calabar, Enugu, Nnewi, and Abakaliki, the leading indications for caesarean section were among the following: cephalopelvic disproportion, previous caesarean section, fetal distress, hypertensive disorders in pregnancy, obstructed labour, breech presentation, antepartum haemorrhage, suspected fetal macrosomia, prolonged labour/poor progress in labour and failed induction of labour. [12][13][14][15][16] Similar patterns were reported from the studies done in Sokoto, Gwagwalada, Zaria, Gombe, Maiduguri, Birnin Kebbi, Birnin Kudu, Sagamu, Lagos, Awka and Jos.…”

Section: Discussionmentioning

confidence: 84%

“…[12][13][14][15][16] Similar patterns were reported from the studies done in Sokoto, Gwagwalada, Zaria, Gombe, Maiduguri, Birnin Kebbi, Birnin Kudu, Sagamu, Lagos, Awka and Jos. [17][18][19][20][21][22][23][24][25][26]28 It was found that, among the leading indications for elective caesarean section in this study were previous caesarean section, breech presentation, suspected fetal macrosomia, abnormal lie and presentation, and twin and higher order multiple pregnancies which are a common trend. Some (5.6%) of the elective caesarean sections were done for prevention of mother to child transmission of HIV; this is relatively high, close to the 7.34% reported in Calabar and reflective of the prevalence of HIV in the south-south region of the country.…”

Section: Discussionmentioning

confidence: 96%

“…7,8 The factors driving this continuing increase in caesarean section rates; both intrapartum and planned caesarean sections are complex and multifactorial, and includes health systems factors, health care provider factors, patient factors and social factors. 6,[9][10][11] In 2014, regional analysis of caesarean section rate at population level showed 40.5% in Latin America and Caribbean, 32.3% in North America, 25.0% in Europe, 19.2% in Asia, 31.1% in Oceania, and 32.3% in Australia and New Zealand, but in Africa, with countries like Rwanda, Zambia and Nigeria having rates as low 7.1%. 3.0% and 2.0% respectively, the region recorded an average rate of 7.3%.…”

Section: Introductionmentioning

confidence: 99%

“…In teaching hospitals, documented caesarean section rate was 30.3% in Port Harcourt, 25.6% in Calabar, 27.6% in Enugu, 18.5% in Nnewi, 16.4% in Abakaliki, 11.3% in Sokoto, 21.4% in Abuja, 24.5% in Zaria, 19.8% in Gombe, 11.8% in Maiduguri, 17.69% in Birnin Kudu, 20.3% in Birnin Kebbi, 32.9% in Sagamu, and 40.1% in Lagos. [12][13][14][15][16][17][18][19][20][21][22][23][24][25] In general hospitals, 10.4% was documented in Awka and 5.39% in Calabar, while a private hospital in Jos recorded 8.9%. [26][27][28] This trend exists despite a population level rate as low as 2%, suggesting that assess to caesarean section is skewed; whereas a lot of women lack access to caesarean section to save their lives and that of their babies, some might be undergoing unnecessary procedures.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Towards optimizing caesarean section: a five-year review of caesarean sections at a Southern Nigeria hospital

Osegi

Makinde

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Monitoring caesarean sections at hospital level is essential to reduce unnecessary caesarean sections while still ensuring adequate access to caesarean section. This study was conducted to determine the caesarean section rate and indications for caesarean section at the study centre and provide objective data for institutional interventions towards reducing unnecessary caesarean sections in the centre.Methods: A retrospective descriptive study of patients that had caesarean sections between 1st January 2013 and 31st December 2017 at the Federal Medical Centre, Yenagoa, Nigeria. Data were analyzed using Statistical Package for Social Sciences version 22.Results: There were 5,793 deliveries and 1,654 were by caesarean section. The average caesarean section rate was 28.6%. The leading indications for caesarean section were cephalopelvic disproportion (26.6%), previous cesarean section (18.2%), suspected fetal distress (11.2%), severe preeclampsia/eclampsia (7.9%), obstructed labour (6%), and breech presentation (5.9%).Conclusions: The 28.6% caesarean section rate in this study falls within a widely varied rate across Nigeria at hospital level but is comparable to rates within the south-south geopolitical zone of Nigeria. The leading indications for caesarean section are modifiable, thus there is room for institutional intervention to reduce unnecessary caesarean sections. Collaborative research between institutions is required to assess peculiar regional determinants of caesarean section towards developing suitable interventions to reduce unnecessary caesarean sections regionally.

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FIGO opinion paper: Drivers and solutions to the cesarean delivery epidemic with emphasis on the increasing rates in Africa and Southeastern Europe

Visser,

Ubom,

Neji

et al. 2023

Intl J Gynecology & Obste

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Cesarean delivery rates are rapidly increasing in Southeastern Europe (to more than 60%), North Africa (with a rate as high as 72% in Egypt), and in urban areas in Southern Africa (a rate of over 50% in Lagos, Nigeria). Data on the background to these increases are scarce, but likely to include poor birthing facilities in general hospitals, convenience for the doctor, private medicine, fear of litigation, socioeconomic status, shortage of midwives and nurses, and disappearance of vaginal instrumental deliveries. Options to reverse cesarean delivery trends are discussed. In this context there is a need to be better informed about how women are being counseled regarding vaginal or cesarean delivery. The long‐term consequences in subsequent pregnancies for mothers and children may well be largely ignored, while these risks are highest in LMICs where higher birth numbers are desired. FIGO has begun discussions with obstetric and gynecologic societies, healthcare bodies, and governments in several countries discussed in this article, to find ways to lower the cesarean delivery rate. The requests came from the countries themselves, which may prove beneficial in helping advance progress.

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Cesarean section in Ahmadu Bello University Teaching Hospital Zaria, Nigeria: A five-year appraisal

Cited by 6 publications

References 0 publications

Caesarean delivery and the attendant FETO-maternal aftermath at a rural hospital in South Southern Nigeria

Caesarean delivery and the attendant FETO-maternal aftermath at a rural hospital in South Southern Nigeria

Towards optimizing caesarean section: a five-year review of caesarean sections at a Southern Nigeria hospital

FIGO opinion paper: Drivers and solutions to the cesarean delivery epidemic with emphasis on the increasing rates in Africa and Southeastern Europe

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