Trends in Elective Caesarean Section at the Jos University Teaching Hospital, Jos Nigeria

Abstract

Context: Elective caesarean sections have been considered safer for both mother and the foetus compared to emergency caesarean sections. Paradoxically emergency caesarean sections have continued to form majority of caesarean deliveries in our facility. Objective: The objective of this study was to determine the caesarean section rate, indications and trend associated with elective caesarean delivery. Study design: A retrospective study of the clinical records of all patients that had caesarean section between 1 st January 2003 and 31 st December 2007 at the Jos University Teaching Hospital, Jos. Data on the number and type of caesarean section and indication for the caesarean section was analysed using descriptive statistics. Results: During the 5 year study period, 2666 caesarean sections were performed out of 13,611 total deliveries giving a caesarean section rate of 19.6%. Elective and emergency caesarean sections accounted for 757 (28.4%) and 1909 (71.6%) of the cases respectively. The rate of elective caesarean section increased from 25.4% in 2003 to 26.5% in 2005 and 32.6% in 2007. Repeat caesarean section (24.7%), HIV in pregnancy (23.0%), bad obstetrics history (11.4%) were the leading indications for elective caesarean operation. Conclusion: The rising trend in the elective caesarean section rate as identified in this study strengthens the need for better patient selection together with improved counseling on its benefits and risks. This is because despite the fact that it is safer than emergency caesarean operation, it also has its own shortcomings and complications.