Trends In The Rates Of Caesarean Deliveries At A University Teaching Hospital In Lagos, Nigeria

Abstract

Background: Caesarean section is a common procedure that impacts greatly on maternal and perinatal outcome. This study reviewed the trends in the rates and types of Caesarean deliveries, the common indications and the associated maternal mortality at the Lagos University Teaching Hospital (LUTH) over a 5-year period.
Methods: A retrospective review of all caesarean sections carried out at the LUTH obstetric unit over a 5-year period between January 2007 and December 2011.The case notes of all women who had Caesarean deliveries during the study period were retrieved from the Medical records Department and the relevant information extracted. The data was analyzed using SPSS version 20.0 for Windows and
then presented in simple descriptive statistics using tables and charts.
Results: Caesarean section rate for the reviewed period was 45.6%. The most frequent indication was for the prevention of mother to child transmission (PMTCT) in HIV positive women with high viral load (24.3%). Maternal mortality following Caesarean section was 0.4% and this was most commonly associated with complications of hypertensive disorders of pregnancy (35.3%).
Conclusions: The overall Caesarean section rate in Lagos is high. Improved antenatal care, reduction in primary Caesarean section rate, early and consistent use of antiretroviral therapy in HIV-infected pregnant women, improved skills in the use of instrumental delivery will help in reducing this unacceptably high Caesarean section rate.

Keywords: Caesarean, LUTH, maternal mortality, PMTCT