Trend in cesarean section in private practice multi-specialist practice in Lagos, Nigeria – a 5 year survey

Abstract

Cesarean section has become one of the most widely performed operations in the world and its rising trend has paved a way for improved modern obstetric outcomes. It is however accompanied by its fair share of morbidity. The shift in the current practice of vaginal delivery to cesarean sections has become a source of concern in the public health sector and the indications for this trend can be attributed to several factors. The aim of this study is to examine the prevalence and indication of cesarean section in a private teaching hospital. A retrospective analysis of all cesarean sections performed at EKO Hospital, Lagos from January 1^st 2010 to December 31^st 2014. Of the 2,881 births, 1,628 of these were cesarean sections with a rate of 57%. Emergency cesarean section was performed in 27% while elective cesarean section was 30%. The common indications for cesarean section were previous cesarean section and cephalopelvic disproportion. There is an increased rise toward delivery by cesarean section in this study. Previous cesarean section and cephalo-pelvic disproportion were the most prevalent indications. Several measures should be taken to reduce the inclination towards primary cesarean section and adopt vaginal delivery which is perhaps much safer. Counseling for Vagina birth after Caesarean (VBAC), health education of the populace and knowledge sharing at antenatal, as well as the use of pathogram by health care personnel has been shown to reduce the increase in cesarean section rate.

Keywords: Cesarean section, VBAC, morbidity, EKO Hospital