Feto-maternal outcomes of caesarean delivery in Federal Medical Centre, Asaba: a two year review

Jombo, Sunday; Ossai, Chukwuma; Onwusulu, Daniel N; Ilikannu, Samuel; Fagbemi, Adeniyi

doi:10.4314/ahs.v22i1.22

Cited by 4 publications

(7 citation statements)

References 14 publications

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“…Some of the reasons averred for this finding include the inadequate growth of the bony pelvis due to poor nutrition and poor supervision of the labour processes. Previous caesarean section was the second most commonest indication for surgery and this sequence is replicated by other studies [6,9,14,15,19] . A major contributory factor in the CSR in this study was that none of the patients with two or more previous caesarean sections was selected for vaginal birth after caesarean section.…”

Section: Discussionsupporting

confidence: 67%

“…Anaemia was the commonest cause of maternal morbidity. This finding was held by other researcher [6,7,27] whereas other authors [9,16,28] reported surgical site infection as the commonest maternal postoperative complication. This result is not surprising because it is mainly a rural area, where poverty is prevalent and there was difficulty in obtaining blood for transfusion when needed.…”

Section: Discussionmentioning

confidence: 73%

“…2,4 This low prevalence portends poor availability of/accessibility to comprehensive essential obstetric care services in the countries/region [3,5] . Reported caesarean section rate across Nigeria ranges 2.1% -38.8% [5][6][7] . Caesarean section is the most common surgical operation in obstetric practice for a myriad of reasons.…”

Section: Introductionmentioning

confidence: 99%

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Caesarean delivery and the attendant FETO-maternal aftermath at a rural hospital in South Southern Nigeria

Alabrah¹,

Abasi²,

Ozori³

2022

Int. J. Clin. Obstet. Gynaecol.

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Background: Caesarean delivery is a necessary tool in the management of obstetric patients when indicated. However, there is general apprehension about the increasing proportion of births by caesarean section (CS) across the globe. Objectives: To ascertain the CS rate (CSR), the indications and the outcomes of caesarean delivery in the hospital. Methodology: The obstetric and theatre records of all caesarean deliveries at Federal Medical Centre Yenagoa, Otuoke outreach, South-South Nigeria, between January 2017 and December 2021 were assessed retrospectively. Generated data were analyzed using SPSS version 23. Results: There were 770 deliveries, out of which 104 were caesarean deliveries, giving a CSR of 13.5%. The majority, 71 (68.3%) of the patients had emergency caesarean delivery while 33 (31.7%) had an elective caesarean delivery. The commonest indication for caesarean delivery was cephalopelvic disproportion (CPD) (27.9%) followed by previous CS and breech in primigravida (17.3% and 7.7% respectively). The majority of the patients, 58 (55.8%) were booked while 46 (44.2%) were unbooked. The commonest morbidity encountered was anaemia which complicated 21.1% of cases. There was one maternal death and six perinatal deaths giving maternal and perinatal mortality rates of 960/100,000 and 49/1000 respectively. Conclusion:The caesarean section rate was within the limits laid down by the World Health Organization. CPD was the chief indication for CS followed by repeat CS and breech in primigravida. Efforts to maintain the CS rate, within acceptable limits, as noted in this study, should be continued.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 73%

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Caesarean delivery and the attendant FETO-maternal aftermath at a rural hospital in South Southern Nigeria

Alabrah¹,

Abasi²,

Ozori³

2022

Int. J. Clin. Obstet. Gynaecol.

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…The raw proportions (W = 0.94 p -value < 0.01) deviated less further from a normal distribution after logit transformation (W = 0.96, p -value = 0.03). The prevalence of elective and emergency CS in facilities was reported from 33 studies [ 21 , 22 , 24 – 30 , 32 – 42 , 44 , 45 , 48 , 50 , 52 , 55 – 60 , 62 , 65 ].…”

Section: Resultsmentioning

confidence: 99%

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

Osayande,

Ogunyemi,

Gwacham-Anisiobi

et al. 2023

Reprod Health

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Background Over 80,000 pregnant women died in Nigeria due to pregnancy-related complications in 2020. Evidence shows that if appropriately conducted, caesarean section (CS) reduces the odds of maternal death. In 2015, the World Health Organization (WHO), in a statement, proposed an optimal national prevalence of CS and recommended the use of Robson classification for classifying and determining intra-facility CS rates. We conducted this systematic review and meta-analysis to synthesise evidence on prevalence, indications, and complications of intra-facility CS in Nigeria. Methods Four databases (African Journals Online, Directory of Open Access Journals, EBSCOhost, and PubMed) were systematically searched for relevant articles published from 2000 to 2022. Articles were screened following the PRISMA guidelines, and those meeting the study’s inclusion criteria were retained for review. Quality assessment of included studies was conducted using a modified Joanna Briggs Institute’s Critical Appraisal Checklist. Narrative synthesis of CS prevalence, indications, and complications as well as a meta-analysis of CS prevalence using R were conducted. Results We retrieved 45 articles, with most (33 (64.4%)) being assessed as high quality. The overall prevalence of CS in facilities across Nigeria was 17.6%. We identified a higher prevalence of emergency CS (75.9%) compared to elective CS (24.3%). We also identified a significantly higher CS prevalence in facilities in the south (25.5%) compared to the north (10.6%). Furthermore, we observed a 10.7% increase in intra-facility CS prevalence following the implementation of the WHO statement. However, none of the studies adopted the Robson classification of CS to determine intra-facility CS rates. In addition, neither hierarchy of care (tertiary or secondary) nor type of facility (public or private) significantly influenced intra-facility CS prevalence. The commonest indications for a CS were previous scar/CS (3.5–33.5%) and pregnancy-related hypertensive disorders (5.5–30.0%), while anaemia (6.4–57.1%) was the most reported complication. Conclusion There are disparities in the prevalence, indications, and complications of CS in facilities across the geopolitical zones of Nigeria, suggestive of concurrent overuse and underuse. There is a need for comprehensive solutions to optimise CS provision tailor-made for zones in Nigeria. Furthermore, future research needs to adopt current guidelines to improve comparison of CS rates.

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Second Stage of Labor Cesarean Section Maternal and Fetal Outcomes

Ahazeej,

Ameer,

Hajar

et al. 2024

Clin J Obstet Gynecol

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Background: Cesarean section at the second stage of labor occurs when the mother requires delivery with full dilatation of the cervix by cesarean section (CS), which poses a risk to the mother and fetus. Purpose: To study the maternal and fetal outcomes of second-stage cesarean section. Methods: This comparative study was conducted at Alhasahisa Teaching Hospital from August 2021 to January 2022. The study sample comprised 226 women who fulfilled the inclusion criteria, including 113 who delivered by second-stage cesarean section and 113 who delivered by first-stage labor cesarean section as controls. Data were collected using a questionnaire filled out by doctors after informed consent was obtained. Results: The common indications in women who delivered via second-stage cesarean section were fetal distress in 62(51.9%), obstructed labor in 26(23%), and failure to progress in 25(22.1%). In women who underwent first-stage cesarean section, the common indications were failure to progress in 85(75.2%), fetal distress in 16(14.2%), and chorioamnionitis in 12(10.6%) (p < 0.05). The reported maternal complications in women who underwent second-stage cesarean section were postpartum hemorrhage in 34(30.1%), sepsis in 11(9.7%), prolonged labor in eight (7.1%), extended tears in four (3.5%), umbilical cord prolapse in three (2.7%), and episiotomy in three (2.7%). The admission to the neonatal intensive care unit (NICU) and the causes of admission were more common among the babies of the women delivered by second-stage cesarean section than the babies of the women delivered by first-stage cesarean section (p value < 0.05). Maternal complications in women who underwent second-stage cesarean section included postpartum hemorrhage in 34(30.1%), sepsis in 11(9.7%), prolonged labor in 8(7.1%), uterine extension in 4(3.5%), umbilical cord prolapse in 3(2.7%), and episiotomy in 3(2.7%) (p < 0.05). Conclusion: Second-stage labor cesarean section showed more complications of postpartum hemorrhage, sepsis, and extended tears, as well as more fetal complications, such as admission to the neonatal intensive care unit, fresh stillbirths, low Apgar scores, and birth asphyxia.

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Feto-maternal outcomes of caesarean delivery in Federal Medical Centre, Asaba: a two year review

Cited by 4 publications

References 14 publications

Caesarean delivery and the attendant FETO-maternal aftermath at a rural hospital in South Southern Nigeria

Caesarean delivery and the attendant FETO-maternal aftermath at a rural hospital in South Southern Nigeria

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

Second Stage of Labor Cesarean Section Maternal and Fetal Outcomes

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