Research and Reports in Gynecology and Obstetrics

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Indications and the materno-foetal outcome of caesarean section in a secondary health facility in obudu, south-south Nigeria

Background: Caesarean section (CS) is an important tool in obstetric care for the reduction of maternal and foetal morbidities and mortalities. This study was done to determine the CS rate, the indications and maternal and foetal outcome of emergency and elective caesarean sections at the Sacred Heart hospital Obudu, Cross River State.
Method: A retrospective review of clinical records of all patients delivered by CS from September 2011 to August 2016 at the Sacred Heart hospital Obudu, Cross River State, Nigeria was conducted.
Results: There were 2445 deliveries with 453 caesarean sections during the review period giving a CS rate of 18.1%. Emergency CS accounted for 338(74.6%), while elective CS accounted for 115(25.6%). The main indications for emergency CS were cephalo-pelvic disproportion (CPD) (16.9%) and obstructed labour (16.0%) followed by breech deliveries. Previous CS was the main indication for elective CS (50.4%). Generally the maternal and foetal outcome of elective CS was better than emergency CS. There were 4 deaths all accounted for by emergency CS giving a CS mortality of 0.9%. Maternal morbidities like post-partum haemorrhage, sepsis, and prolonged hospital stay were worse among the emergency CS patients. Some conditions like obstetric fistula and ruptured uterus were found only amongst the emergency CS patients. For foetal outcome, poor Apgar score, sepsis, death, jaundice and need for referral were worse among emergency CS patients.
Conclusion: The incidence of CS is high in this centre with higher rate of emergency over elective CS. Also the maternal and foetal outcomes of emergency CS were worse than those of elective CS.

Author(s): Maanongun MT, Ornguze AA, Ojabo AO, Eka PO