Outcome of caesarean delivery at the aminu kano teaching hospital, Kano

Abstract

To determine the sociodemographic characteristics, indications and feto-maternal outcome among patients who had Caesarean section at Aminu Kano Teaching Hospital, Kano, Nigeria. Methods: A review of all Caesarean sections (C/S) that were performed at Aminu Kano Teaching Hospital, Kano, Nigeria, between 1st January 2001 and 31st December 2005 was carried out. The study variables of interest were the sociodemographic characteristics of the patients, indications and types of C/S, and feto-maternal outcome. Results: The caesarean section rate in this review was 13.7%. Emergency C/S accounted for 87.9%, while 12.1% were done electively. Among them 52.4% were booked while 47.6% were unbooked, giving a C/S rate of 9.2% for booked and 29.2% for unbooked patients respectively. The leading indications for emergency C/S were pre- eclampsia/eclampsia and cephalo-pelvic disproportion (CPD)/obstructed labour, while for elective C/S, it was two or more previous C/S and breech presentation. The maternal mortality rate was 262.3/100,000, due mainly to pre-eclampsia/eclampsia, CPD/obstructed labour, sepsis and postpartum haemorrhage. Perinatal mortality was 19.7/1000, with birth asphyxia, prematurity and neonatal sepsis being the leading causes. Feto-maternal morbidity and mortality were significantly higher among unbooked patients and those that had emergency C/S. There was increasing trend in the C/S rate during the period of study from 12.7% in 2001 to 14.8% in 2005 (χ2trend = 5.254, P= 0.02190). Conclusion: Pre-eclampsia/eclampsia and (CPD)/obstructed labour were the leading indications for C/S in this study. Unbooked status and emergency C/S were found to be responsible for most of the fetomaternal morbidity and mortality. There is the need for increasing efforts to ensure that our pregnant women avail themselves of the available antenatal care facilities, in order to reduce the fetomaternal morbidity and mortality from caesarean section.