Cesarean Section Rate and its Outcome in a Tertiary Hospital in Enugu, South East Nigeria

Abstract

Background: Cesarean delivery is an essential component of comprehensive emergency obstetric care, an intervention that saves the life of pregnant women. Although the cesarean section (C/S) rate varies from one region to the other, there is generally a rising trend in the C/S rate globally with its associated benefits and attendant challenges.

Objective: The study aimed to determine the C/S rate and its outcome at the University of Nigeria teaching hospital, Enugu.

Methods: All pregnant women undergoing C/S during the 12 months study period from 1st January to 31st December 2012 at UNTH, Enugu, South east Nigeria were consecutively recruited. Cesarean delivery group were compared with vaginal delivery group using maternal mortality ratio (MMR) and perinatal mortality rate (PMR) as outcome measures. Relevant data were obtained and analyzed using Epi info statistical software.

Results: There were 256 C/S and 998 total deliveries, giving a C/S rate of 25.7%.The maternal mortality rate (MMR) in the C/S group was significantly higher than the vaginal delivery group (MMR= 1619 vs 139/ 100 000 livebirths, p value = 0.02. RR= 11.46, 95% CI (1.29, 102.04). The perinatal mortality rate in the two groups was not statistically different, (53.6 v 54.9/ 1000 live births, p value=0.93, RR =0.97, 95% CI (0.54, 1.77), however un-booked status was a predisposing factor for maternal and perinatal deaths.

Conclusion: The C/S rate from the study was high, although with good outcome. However, MMR was significant higher in the Cesarean group compared with those that had vaginal delivery.