A Four-Year Review of Caesarean Section at a Secondary Healthcare Facility in Abuja, Northcentral Nigeria

Caesarean section in Abuja

Abstract

A Four-Year Review of Caesarean Section at a Secondary Healthcare Facility in Abuja, Northcentral Nigeria

Abstract

Background: Caesarean section (CS) rates have been on the increase worldwide for various reasons. Despite the global increase in rates, there still exist wide disparities in rates between regions, countries and within countries. The indications for CS have evolved to include non-medical indications such as maternal and obstetricians’ preferences, for social reasons.

Aim: The aim of the study was to determine the rate, indications, outcomes and complications of CS in a secondary healthcare facility in Abuja, Northcentral Nigeria.

Materials and method: This was a retrospective study of all cases of CS performed at Maitama District Hospital, Abuja between 1^st January 2019 and 31^st December 2022. The relevant data were extracted from the patients’ records in the hospital’s Electronic Medical Records database and also from the delivery registers in the labour ward, and operating theatre records. Data analysis was done using SPSS version 26. Results were presented in tables as frequencies and simple percentages.

Results: During the study period, there was a total of 6,438 deliveries, with 2,800 CS, giving an overall CS rate of 43.5%. Emergency CS was the commonest type (53.3%). The commonest indications for the CS were CPD (38.7%), fetal distress (26.4%), and two or more previous CS (11.1%). Anaemia was the commonest maternal postoperative complication accounting for 25.6% of cases. There were six maternal deaths (0.2%). Majority (81%) of the babies had good Apgar scores with 14.9% having various degrees of birth asphyxia. There were 106 perinatal deaths (4.1%).

Conclusion: The CS rate in this study is substantially higher than both the WHO recommended rates and Nigeria national average. Indications were varied with contributions from CPD, fetal distress, breech presentation, previous CS and maternal request worthy of note. Maternal and perinatal outcomes were good, despite the high proportion of emergency CS.

Measures to improve access to antenatal care and labour management practices, plus patient education, will help stem the rising CS rates.

Key words: Caesarean section, indications, outcome, complications, Abuja