Caesarean delivery: An experience from a tertiary institution in north western Nigeria.

OBJECTIVE To assess the overall caesarean section (CS) rate, indications and outcomes in a tertiary hospital in North-western Nigeria. MATERIALS AND METHODS A cross-sectional study carried out over a period of two years. All patients who had caesarean section at any time within the day were noted and followed up till discharge. The socio-demographic data, types of CS, anaesthesia, indications, abdominal wall and uterine incisions, cadre of surgeon and feto-maternal outcomes were documented in a proforma. Statistical analysis was carried out using the EPI INFO 3.5.1 (CDC Atlanta Georgia, USA). RESULT The caesarean section rate was 11.3% (504/4462) of total deliveries. The highest rate of 44.6% (225/504) was among the primipara. The most common age group involved was 25 to 29 years. The emergency rate was 57.1% (288/504), while elective CS constituted 42.9% (216/504) of cases. The most common indication for emergency CS was obstructed labour 25.7% (30/288) and previous CS 39.8% (86/216) for elective CS. The complication rate was 13.3% (67/504) and the main complication was haemorrhage 59.7% (40/67). Complications were more with emergency CS compared to elective surgery (χ2 = 6.633, df = 1, P < 0.01) and with junior residents (χ2 = 15.9, df = 1, P < 0.001). There were 10 maternal and 60 perinatal deaths. CONCLUSIONS The rate of caesarean section has been increasing gradually. There is need to improve on facilities and manpower in order to reduce morbidity and mortality.