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Tropical Journal of Obstetrics and Gynaecology

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Caesarean Section at the University of Benin Teaching Hospital Revisited

Patrick I. Okonta, Valentine O. Otoide, Sylvanus A. Okogbenin

Abstract


Context: Regular auditing of caesarean sections is necessary to establish trend, review indications, associated complications and proffer possible solutions to improve outcome.



Objective: To audit caesarean sections done over a 5-year period from January 1996 to December 2000 and to compare such with those from the same hospital 20 years ago.



Materials and Methods: A review of the clinical records of all mothers who had caesarean sections from January 1996 – December 2000 was made. Data on the indications, and on maternal and fetal outcome were extracted and analysed.



Results: The caesarean section (CS) rate was 22.2%. Dystocia (28.2%) was the commonest indications for CS. There were a total of 351 (39.3%) patients with complications, with anaemia being the commonest form of morbidity. Eight CS-related deaths were recorded – Maternal Mortality Ratio: 7.8 per 1000. The perinatal mortality rate (PNMR) was 128.3 per 1000 births. Being unbooked was associated with poor maternal and fetal outcome. Compared with 20 years ago, there was an increase in the CS rate from 10.1% to 23%. The indications remained essentially the same. There was a lowering of the maternal morbidity rate from 54.1 to 39.3%, but an increase in the PNMR from 88 to 128.3 per 1000 births.




Conclusion: The CS rate has more than doubled in the two decades since the last audit. Booking of high-risk cases in tertiary institutions and early referral of complicated cases to these institutions should be encouraged. The neonatal care services should be improved to cope with complications in neonates.




Key Words: Caesarean Section, Maternal Morbidity, Perinatal Audit




[Trop J Obstet Gynaecol, 2003, 20: 63-66]



http://dx.doi.org/10.4314/tjog.v20i1.14404
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