Current trends in caesarean section in University of Calabar Teaching Hospital Calabar-Nigeria

Abstract

The rising caesarean section rate is becoming a cause for concern among many obstetricians all over the world more so in developing countries where there is strong aversion to caesarean section. A five year study was conducted between 1998 to 2002 to evaluate incidence of caesarean section in the University of Calabar Teaching Hospital and factors that influence the rising trend in caesarean section rate in our environment and also to find out the case fatality rate associated with this surgical operation. Caesarean section accounted for 19.8% of the total deliveries while spontaneous vaginal delivery accounted for 75.6%. Other modes of deliveries included assisted breech delivery (2.8%), vacuum (1.5%), forceps – (0.5%), destructive operations (0.14%). The caesarean section rate increased progressively from 17.9% in 1998 to 21.9% in 2002. Emergency caesarean sections (80.0%) were more frequently performed than elective cases (20.0%). Majority of the patients (82.9%) were booked while only 17.1% were unbooked. The commonest indication for emergency caesarean section was obstructed labour due to cephalopelvic disproportion (25%), followed closely by fetal distress (13.9%). The case fatality from caesarean section was calculated as 1.29%. It is obvious that there is increase in the caesarean section rate in our environment, which is in line with what is happening in the developed countries where the operation is more liberally used. In consonance with finding in other Teaching Hospitals, caesarean section appears to be on the increase in Nigeria. Although it has been suggested that increased rates of caesarean section would reduce the unusually high perinatal mortality in this area, this has not been subjected to objective scientific analysis.


Keywords: caesarean section, cephalopelvic disproportion, obstructed labour

Mary Slessor Journal of Medicine Vol. 5(1), 2005: 41-45