Caesarean Section in a Tertiary Hospital in South-South, Nigeria: A 3-year Review

Abstract

Background: Caesarean section is the delivery of the foetus, placenta, and foetal membranes through an incision on the abdominal and uterine walls after the age of foetal viability. It is a life-saving surgical procedure, which has helped reduce maternal and perinatal morbidity and mortality over the years.
 Objective: To determine the rates, indications, outcomes, and complications of Caesarean section at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
 Materials and Methods: This research was carried out at the Department of Obstetrics and Gynaecology, Federal Medical Centre (FMC), Yenagoa, Bayelsa State, South-South, Nigeria between 1st January 2018 and 31st December 2020. It was a retrospective study.
 Data was retrieved from the labour ward records, delivery register, theatre records, and patients’ folders during the period under review, and entered into a pre-designed proforma.
 Data were analysed with IBM SPSS version 23.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables.
 Results: About 959 women had Caesarean section (CS) out of 2,263 deliveries, giving a Caesarean section rate of 42.4%. The commonest indication for emergency Caesarean section was cephalopelvic disproportion (36.0%), while that for elective Caesarean section was repeat Caesarean section (19.6%).
 Conclusion: The Caesarean section rate in our Centre is extremely high, almost three times the acceptable upper limit set by the WHO. Encouraging vaginal birth after Caesarean section as a means to reduce this high rate is recommended as it was noted that previous Caesarean section was a leading indication for surgeries.

A 5-year review of obstructed labour and its sequalae in the Federal Medical Centre, Yenagoa, South-South, Nigeria

“…Caesarean section rates have continued to increase worldwide. Our Caesarean section rate in this Centre is 42.4% [33] , and this is mainly due to unbooked patients referred from TBAs and private clinics. This rate is quite higher than that of a number of Centres [33,34] .…”

“…Our Caesarean section rate in this Centre is 42.4% [33] , and this is mainly due to unbooked patients referred from TBAs and private clinics. This rate is quite higher than that of a number of Centres [33,34] . During the study period, there was a maternal mortality rate of 1.9% or 19.2 per 1000 deliveries as one maternal death due to complications following obstructed labour was recorded.…”

Prevalence, indications, and complications of caesarean section in health facilities across Nigeria: a systematic review and meta-analysis

“…Forty-four of these were included in the meta-analysis, having all reported on CS prevalence [ 21 – 63 , 65 ]. However, only 31 articles [ 21 – 24 , 27 , 28 , 30 – 32 , 35 , 37 , 38 , 41 , 42 , 44 – 46 , 48 – 50 , 55 – 61 , 63 , 64 ] reported the indications or complications of CS and, as such, were included in the narrative synthesis. These are presented in the PRISMA flow diagram (Fig.…”

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

“…In 2018 the highest rate of 51% was reported from the capital Lagos, 11 which is a marked increase from the rate of 31% reported in 2010 12 . After Lagos, rates of up to 42.4% have been recorded in the south of the country as of 2021 13 . In Eastern Nigeria, between 2015 and 2019, cesarean rates increased from 16.4% to 34.3% 14,15 .…”