Rising trend and indications of caesarean section at the university of Maiduguri teaching hospital, Nigeria

Abstract

Objective: To determine the trend and indications for the use of caesarean delivery in our environment. Method: A retrospective review of the caesarean sections performed at University of Maiduguri Teaching Hospital from January 2000 to December 2005 inclusive. Results: During the study period, there were 10,097 deliveries and 1192 caesarean sections giving a caesarean section rate of 11.8%. The major maternal indications were cephalopelvic disproportion (15.5%), previous caesarean section (14.7%), eclampsia (7.2%), failed induction of labor (5.5%), and placenta previa (5.1%). Fetal distress (9.6%), breech presentation (4.7%), fetal macrosomia (4.3%), and pregnancy complicated by multiple fetuses (4.2%) were the major fetal indications. The caesarean section rate showed a steady increase over the years (7.20% in 2000-13.95% in 2005), but yearly analysis of the demographic characteristics, type of caesarean section, and the major indications did not reveal any consistent changes to account for the rising trend except for the increasing frequency of fetal distress as an indication of caesarean section over the years, which was also not statistically signifi cant (χ [2] =8.08; P=0.12). The overall perinatal mortality in the study population was found to be 72.7/1000 birth and despite the rising rate of caesarean section, the perinatal outcomes did not improve over the years. Conclusion: Trial of vaginal birth after caesarean section in appropriate cases and use of cardiotocography for continuous fetal heart rate monitoring in labor with confi rmation of suspected fetal distress through fetal blood acid--base study are recommended. A prospective study may reveal some of the other reasons for the increasing caesarean section rate. Les grandes maternelle indications ont été cephalopelvic disproportion (15,5 %), chlorure précédente section (14,7 %), éclampsie (7,2 %), a échoué à induction du travail (5,5 %) et le placenta previa (5,1 %). Détresse foetale (9,6 %), présentation de breech (4,7 %), macrosomia foetal (4,3 %) /et de la grossesse compliquée par plusieurs foetus (4,2 %) ont été les indications du foetus majeures. Le taux de césarienne a montré une augmentation constante au fi l des ans (7.19 % en 2000 à 13.95 % en 2005) mais l'analyse annuelle des caractéristiques démographiques, type de césarienne et les indications majeures n'a révélé tout cohérentes modifi cations apportées à tenir compte de la tendance sauf pour la fréquence accrue des détresse foetale comme une indication de césarienne les années qui a été également pas statistiquement signifi catif (χ [2] = p 8.08 = 0,12) . Le mortalité périnatale globale dans la population de l'étude a été jugée 72.7 / 1000 naissance et malgré le hausse du taux de césarienne, les résultats périnatales ne pas améliorer au fi l des ans. conclusion: procès de naissance vaginal après une césarienne dans les cas appropriés et l'utilisation de cardiotocography pour la continu de fréquence cardiaque foetale surveillance du travail avec la Annals of African Medicine Vo...

Prevalence and Outcome of Cesarean Section at Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal

“…Malnutrition is still major risk factor and responsible for cephalopelvic disproportion in Nepal and other developing countries. These results were similar to study done by Geidam et al (2010) in Nigeria 9 .…”

Caesarean Section Rate in a Tertiary Hospital in Makurdi, North-Central Nigeria

“…It is also higher than 10.5% earlier recorded in a similar study in a secondary level care hospital in Makurdi [16], 10.4% in Awka [17] and 11.85% recorded in Maiduguri [13], but less than the rates of 20.8% to 34.5% recorded in some tertiary institutions in Nigeria [17][18][19]. It is however, similar to 18% reported from Jos, Northern Nigeria [20].…”

“…In developing countries, attributed factors include fear of litigation, liberal use of CS for breech presentation, detection of foetal distress by continuous electronic foetal monitoring among others [13]. In developing countries like Nigeria, some of the reasons may include high incidence of CPD, repeat CS for patients with previous CS, use of foetal heart rate abnormality for the diagnosis of foetal distress, a change in practice standards that reflects an increasing willingness by specialists to resort to CS, unbooked status of patients and late presentation when CS is the safest mode of and above all the referral nature of our hospitals where most of the operations take place.…”

Profile of Caesarean Section in Kirtipur Hospital

“…1,[4][5][6][9][10][11][12][13][14][15][16] The frequency of caesarean section depends on the inherent characteristics of the obstetric population, socio-demographic pattern, referral role of the hospital, department's policies regarding management of cases of dystocia, breech, fetal distress and previous caesarean section, physician factor, medicolegal aspects and consideration of maternal choice and wishes. 1 The higher rate of caesarean section in this study might be due to unavailability of fetal scalp blood sampling for meconium stained liquor, uncertainty of fetal outcome for cord round the neck, bad obstetric history, oligohydramnios and maternal and fetal morbidity and risk of rupture of uterus in previous section patients.…”

“…The objective of caesarean section in the ancient world was mainly postmortem delivery of dead or alive fetus. 1 The incidence of caesarean section varies from hospital to hospital within a country and across nations. 2 There is no consensus about what the ideal caesarean section rate should be.…”