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Caesarean morbidity and mortality at Aminu Kano Teaching Hospital, Kano- A two-year review
Abstract
Background: With the development of antibiotic therapy and modern blood-banking techniques, caesarean section has evolved into one of the safest and most commonly performed major operative procedures.
Objective: To determine the caesarean section rate, its morbidity and mortality in Aminu Kano Teaching Hospital, Kano.
Study Design: A two-year descriptive study from 1st January 2006 to 31st December 2007, in Aminu Kano Teaching Hospital, Kano. All patients that were delivered by caesarean section were included.
Results: There were 6,355 deliveries from 1st January 2006 to 31 st December 2007, out of which 1,005 were by caesarean section, giving a caesarean section rate of 15.8%. Nine hundred and thirty eight (938) case notes were retrieved, out of which emergency caesarean sections were performed in 812 (86.6%) and elective caesarean sections in 126 (13.4%). Of the 938 patients, 434 (46.3%) were booked at Aminu Kano Teaching Hospital, Kano, 314 (33.5%) were booked elsewhere and 190 (20.2%) were unbooked. The commonest indication was cephalo-pelvic disproportion/obstructed labour in 27.7% of the patients, then previous caesarean sections in 18.6%, hypertensive disorders in 14.8% and ante partum haemorrhage in 11.1% of the patients. Three hundred and six (33.6%) of the patients had at least one complication. The common complications were postpartum anaemia (21.3%), prolonged hospital stay (9.4%) and postpartum haemorrhage (4.5%). The caesarean section related mortality rate was 1.1% or 1066/100,000; 80% of which occurred in unbooked patients, 60% occurred in patients with eclampsia, 20% in patients with obstructed labour and the other 20% in patients with ante partum haemorrhage.
Conclusion: Morbidity and mortality from caesarean section is still high, due to the high number of unbooked patients and late referrals. Efforts should be made to educate our women about the importance of antenatal booking and early presentation in labour. Early referrals should be encouraged through continuing education programme for Doctors in private and government hospitals.
