The Rate of Caesarean Section in Nnewi, Nigeria: A 10-year Review
AbstractBackground: There is widespread public and professional concern about the increasing proportion of births by caesarean section (c/s). Objectives: This study is to determine the c/s rate, the indications and the reasons for the high rate. Methods: The obstetric records of all caesarean deliveries that occurred at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South-Eastern Nigeria, between 1st January, 1999 and 31st December, 2008 were reviewed retrospectively. Results: Of the 6,015 deliveries, 1,114 were by C/S giving an overall rate of 18.5%. Caesarian birth rose from approximately 1 in 7 deliveries in 1999 to 1 in 4 deliveries in 2008 and this was 2 statistically significant (x =20.75; df=1; p<0.05). A new peak of 26.9% was recorded in 2008 for C/S rate. The mean age of the patients was 30.8 ± 5.1 years and 37.4% of the patients were primiparous. However, 31.8% of the women were unbooked cases, and the majority (96.4%) of these unbooked cases had emergency C/S. Previous caesarean section (previous scar), was the commonest indication for C/S throughout the study period, accounting for 242 (21.5%) of cases. The other major indications were cephalopelvic disproportion (CPD), 141 (12.3%), obstructed labour, 134 (11.7%), antepartum haemorrhage, 133 (11.6%), pregnancy induced hypertension, 105 (9.1%) and breech presentation, 77(6.7%). Conclusion: The C/S rate has significantly increased during the study period and repeat C/S and CPD were the commonest indications. The efforts to avoid unnecessary C/S should focus on reducing the frequency of first time procedures. Vaginal birth after a previous caesarean section (VBAC) should also be encouraged. Key words: Caesarean section, high rate, review. Afrimedic Journal 2010; 1(1):11-14
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