Markers and the Materno-Foetal Result of Caesarean Section: A Study at the Secondary Health Facility in Obudu, Cross River State, Nigeria | Chapter 1 | Medical Science: Recent Advances and Applications Vol. 3

Background: Caesarean section (CS) refers to the delivery of a foetus, placenta and membranes after the age of viability through an abdominal and uterine incision. Caesarean section is further divided into two subtypes as far as the urgency of the operation is concerned. Elective caesarean section refers to those occasions where the decision to carry out caesarean section is made and planned more than 24 hours before delivery. Caesarean section (CS) is an important tool in obstetric care for the reduction of maternal and foetal morbidities and mortalities. This study was done to determine the CS rate, the indications and the maternal and foetal outcome of emergency and elective caesarean sections at the Sacred Heart Hospital Obudu, Cross River State.

Methods: A retrospective review of clinical records of all patients delivered by CS from September 2011 to August 2016 at the Sacred Heart Hospital, Obudu, Cross River State, Nigeria was conducted. Data for the study were extracted from theatre records, labour ward records and neonatal ward records using a structured questionnaire. The information obtained included socio-demographic variables, obstetric history and outcome of caesarean section. The data collected was checked for its completeness, entered into a computer and analysed using SPSS version 20.0. Frequencies.

Results: There were 2445 deliveries with 453 caesarean sections during the review period, giving a CS rate of 18.1%. Emergency CS accounted for 338(74.6%), while elective CS accounted for 115(25.6%). The main indications for emergency CS were cephalo-pelvic disproportion (CPD) (16.9%) and obstructed labour (16.0%), followed by breech deliveries. Previous CS was the main indication for elective CS (50.4%). Generally, the maternal and foetal outcomes of elective CS were better than emergency CS. There were 4 deaths, all accounted for by emergency CS, giving a CS mortality of 0.9%. Maternal morbidities like post-partum haemorrhage, sepsis, and prolonged hospital stay were worse among the emergency CS patients. Some conditions, like obstetric fistula and ruptured uterus, were found only amongst the emergency CS patients. For foetal outcome, poor Apgar score, sepsis, death, jaundice and need for referral were worse among emergency CS patients.

Conclusion: The incidence of CS is high in this centre, with a higher rate of emergency than elective CS. Also, the maternal and foetal outcomes of emergency CS were worse than those of elective CS. Caesarean section remains an important tool in obstetrics practice for the reduction of maternal and neonatal morbidity and mortality. In this review, the main indications for emergency CS were CPD, obstructed labour and breech presentation, while previous CS was the main indication for elective CS.

 

Author (s) Details

Maanongun MT
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Ornguze AA
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Ojabo AO
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Eka PO
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v3/2630

Caesarean Section at the Rivers State University Teaching Hospital, Southern Nigeria: A Five-year Review | Chapter 05 | New Horizons in Medicine and Medical Research Vol. 9

 This chapter looked at the occurrence, trend, and indicators of CS at the Rivers State University Teaching Hospital (RSUTH) in order to enhance management results.

Between January 1, 2015, and December 31, 2019, the RSUTH performed 5,598 caesarean sections (3699 emergency, 1899 planned). The data was analysed using IBM Statistical Product and Service Solutions (SPSS) version 25.0 Armonk, New York. There were 13,516 births and 5,598 instances of CS throughout the study period, resulting in a prevalence of 41.4 percent or 414 per 1000 deliveries. 66.1 percent of CS cases were emergency, while 33.9 percent were planned. There was an increase trend in CS across the review period. The participants' average age was 32.301.04 years (95 percent CI:30.26,34.34). 35-39 years old was the median age group, accounting for 33.2 percent, followed by 30-34 years old (26.2 percent ). The majority of the patients were multiparous [3396 (60.7%)], married [4890 (87.4%), Christians [5540 (99%)], and had a tertiary degree [2800 (50%)]. Previous caesarean section (34 percent) was the most prevalent reason for CS at RSUTH, followed by cephalopelvic disproportion (75 percent), foetal distress (41 percent), preeclampsia (39 percent), and multiple gestation (25 percent).

The number of caesarean sections performed at RSUTH is increasing. Despite the fact that CS saves lives, efforts should be made to lower the rate to the WHO-recommended level, particularly in LMICs where CS is detested.

Author(S) Details

Felix Chikaike Clement Wekere
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria and  Department of Community Medicine, College of Medical Sciences, Rivers State University, Port Harcourt, Nigeria.

Rose Sitonma Iwo-Amah
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria.

Joseph Ngozi Kwosah
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria.

Adetomi Bademosi
Department of Community Medicine, College of Medical Sciences, Rivers State University, Port Harcourt, Nigeria.

Simeon Chijioke Amadi
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria.

Paul Ledee Kua
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria.

Dickson Hezekiah John
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria.

View Book:- https://stm.bookpi.org/NHMMR-V9/article/view/6898