Caesarean Delivery at a Teaching Hospital, South-South Nigeria: A Five-Year Review

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

“…34 The trend observed in the age distribution of patients showing that most of the patients that delivered by caesarean section were within the 25-29 years age range and followed by the 30-34 years age range is similar to what also obtained in studies done in other centres in the south-south, south-east, north-west regions of Nigeria and the federal capital territory. 12,13,14,17,18 However, unlike most of these other studies where the 20-24 years age range followed after the above mentioned age ranges, the 35-39 years age range was what followed in this study with the 20-24 years age range being the fourth common. This trend may explain why most of the patients who delivered by caesarean section in this study were multiparous and different from what was reported in most of the other studies with similar pattern of patient age, where most of the women were primigravida except in Sokoto where most of the women were not primigravida but were also of lower parity (primiparous).…”

“…The caesarean section rate of 28.6% from this study is slightly higher than rates from similar studies of 25.6% and 27.6% recorded in teaching hospitals in Calabar and Enugu respectively, and slightly lower than the 30.3% recorded from a similar study in another teaching hospital in Port Harcourt. [12][13][14] These are tertiary level health facilities in the south of Nigeria like the study centre that possibly share the same peculiarities in terms of population being served, and hospital capability. The comparable caesarean section rates though with slight variation is a ground to encourage further studies that would purposefully assess and compare caesarean delivery across these institutions in line with WHO recommendation, and highlight relevant local/regional clinical and nonclinical modifiable indications for caesarean delivery.…”

“…This trend may explain why most of the patients who delivered by caesarean section in this study were multiparous and different from what was reported in most of the other studies with similar pattern of patient age, where most of the women were primigravida except in Sokoto where most of the women were not primigravida but were also of lower parity (primiparous). [12][13][14]17,18 There were more booked than unbooked women in this study because apart from the study centre being a referral hospital where poorly managed and complicated labour cases (usually from traditional birth attendants and patients who cannot afford the cost of caesarean section in private hospitals) are referred to, it also caters for patients who primarily receive antenatal care in the facility. The patients that receive antenatal care in the study centre are a mix of low and middle social classes.…”

“…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.…”

Determination of the Intervention Strategies for the Prevention of Fetal Macrosomia Dependent Cesarean Sections in Nigeria

“…Other indications include conditions where other complications, such as breech presentation, fetal macrosomia and severe preeclampsia/eclampsia, are presenting in labor in a woman who has had a previous uterine scar. [2] Cesarean section rates have risen to almost 50% in China, [3] 50% in Brazil, [4] 32% in U.S.A, [5] and variable rates of 14.3-35.5% in the various geopolitical regions of Nigeria [6,7,8,9,10]. Though the international health community has recommended that every effort should be made to provide cesarean section for women in need rather than striving to achieve specific rates, there are long and short term risks for cesarean sections, especially when they are carried out by health care providers in settings that lack the facilities and/or capacity to properly conduct safe surgery and treat surgical complications as are commonly found in developing countries such as Nigeria.…”