Analysis of Caesarean Deliveries (CD) at a Tertiary Hospital in Northeastern Nigeria: A 5 Year Review.
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Keywords
Caesarean delivery, trend, outcome, tertiary hospital, Northeastern Nigeria
Abstract
Background: One of the most commonly performed surgical procedures in Obstetrics is caesarean delivery (CD), and certainly the oldest surgical operation. Caesarean delivery is life-saving, especially when there is a failure or contraindication to vaginal delivery. However, the health risk and the cost of the surgery may be quite challenging, especially in low-resource countries like Nigeria. The observed increased prevalence rate in recent times is alarming and has become a major public health concern, calling for regular appraisal of its indications in order to reduce the prevalence. This study was undertaken to determine the prevalence, trend, indications, maternal and foetal outcomes at Modibbo Adama University Teaching Hospital, Yola, Adamawa State. Nigeria.
Methodology: It was a hospital-based retrospective study of all the cases of CD undertaken between 1st January 2018 and 31st December 2022. Names and hospital numbers of patients were identified; the case folders were traced and retrieved. Necessary information was obtained and analyzed using SPSS version 17 software. Results were presented in percentages, simple graphs, and ratios.
Results: During the years under review, there were 8568 deliveries, out of which 2707 had cesarean delivery, giving a cesarean delivery rate of 31.6%. The major maternal indication was prolonged obstructed labor, 627 (23.09%), while that of foetal indication was foetal distress, 418 (15.44%). The trend of caesarean delivery in this study showed a steady increase between 2018 and 2019 and 2021 to 2022, with a drop in 2020. This was due to the lockdown following the COVID-19 pandemic in that year. The maternal mortality ratio was 776/100,000 live births, and case fatality was 0.8%, while perinatal mortality was 41/1000 births.
Conclusion: The caesarean delivery rate in this study was very high when compared to most teaching hospitals in Nigeria. Effort should therefore be made to reverse the ugly trend. Therefore, a thorough and meticulous assessment of patients should be done before a decision is taken for surgery, especially elective caesarean deliveries.
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