Caesarean delivery in urban second tier missionary hospital in Nigeria
Objective: To determine the current trend of Caesarean and highlight the role of a major operative obstetric practice in materno-foetal medicine.
Design: Descriptive case study.
Setting: St Philomena Catholic Hospital (SPCH), an urban second tier missionary hospital.
Subjects: One thousand and fourteen (1014) Caesarean deliveries that took place at the centre between January 2009 and December 2013.
Main outcome measures: These were Caesarean section rates, the trend, indications and materno-foetal complications.
Results: The rate of Caesarean birth in this study was 1014(21.0%), EMCS constituted 816(80.5%) and elective CS 198(19.5%).The leading indications for EMCS were cephalopelvic disproportion(CPD)323 (39.6%) and obstructed labor 135(16.5) while previous caesarean section 102(51.5%) and breech presentation 41(20.6%) were the leading indications for elective CS. The major maternal complications were postpartum haemorrhage 7.2% and post-partum anaemia 47.7% for EMCS and the values for ELCS were 6.6% and 36.9% respectively. The perinatal complications were Apgar score <7 at 5 minute 5.1% vs. 1.5% Odd ratio (OR) 3.5, P-value (P) 0.021 and SCBU admission 7.1% vs. 2.6% OR 2.9, P 0.014 respectively for EMCS and ELCS. The composite perinatal complications were 15.2% vs. 7.6%, OR 2.2, P 0.0039.
Conclusion: To the obstetric world, we proffer quality prenatal care, quality labuor supervision and strict case selection based on medical and obstetric merits for Caesarean births.