Elective caesarean section in a tertiary hospital in Sokoto, north western Nigeria

Abstract

Background:Elective caesarean sections have been considered safer for both mother and the fetus compared to their emergency counterpart. However, emergency caesarean sections have continued to form bulk of caesarean deliveries in our facility.Objective:The objective of this study was to determine the caesarean section rate together with the trend, indications, and maternal mortality associated with elective caesarean operation.Materials and Methods:A retrospective analysis of clinical records of all the patients that had caesarean section between January 2002 and December 2010 (9 years) at Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, Nigeria was conducted.Results:During the 9 year study period, 2284 caesarean sections were performed out of 22,985 total deliveries at UDUTH Sokoto, thus giving a caesarean section rate of 9.9%. Emergency and elective operations accounted for 1784 (78.2%) and 498 (21.8%) of the cases respectively. The rate of elective caesarean section increased from 1.7% in 2002 to 3.2% in 2007. Thereafter it declined gradually to 1.8% in 2010. Repeat caesarean section (30.7%) and malpresentation (17.1%) were the most common indications for elective caesarean operation. There were 18 maternal deaths from caesarean section and only one from the elective caesarean procedure.Conclusion:The rising trend in the elective caesarean section rate in this study underscores the need for better and improved patient selection together with counseling on its benefits and risks. This is because despite the fact that it is safer than emergency caesarean operation, it is not entirely devoid of complications. Routine use of spinal anesthesia in performing the procedure should be encouraged.

Caesarean Section and Perinatal Outcome in a Sub-urban Tertiary Hospital in Northwest Nigeria

“…Rates of 16.9% and 18% reported in studies done in southwest, Nigeria were similar to that of the present study. 24,25 Emergency caesarean section rate of 90.4% reported in the present study is higher than those reported by Aisien 20 , Okonofua 26 and Nwobodo 27 but lower than 97.4% reported by Buowari. 29 The implication is that perinatal mortality rate may continue to rise until caesarean section is done as elective rather than emergency procedure.…”

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

“…The increase in caesarean section rates is largely driven by several factors which include societal demands for improved foetal outcome, protection of pelvic floor, and the aspiration of obstetricians to meet these demand [10].…”

“…Elective surgery has been judged to be better than emergency surgery [10,11], moreso the operation avails the patient the benefit of a team of an anaesthetist, neonatologist, obstetrician and the operating theatre staff [2]. Anaesthetic complications are more likely to occur in patients who need emergency caesarean section, and are administered general anaesthesia sooner than 4-6 hours after taking food and fluids [12].…”

Magnitude and Pattern of Caesarean Sections in a Teaching Hospital, Northwest Nigeria: A 5 Year Analysis

“…The World Health Organization (WHO) recommends that the Caesarean section rate should be 10-15% 7 . However, there is wide variation of this rate globally as well as locally 8,9 .…”

“…Although elective Caesarean section is considered safer for both mother and fetus, when compared with emergency Caesarean section, the latter continued to exact its dominance in frequency in most health facilities in Nigeria 8,9 . Regional anaesthesia is generally recommended over general anaesthesia in term of safety for both the parturient and the fetus 10,11 .…”