A Five-Year Review of Caesarean Section at the Rivers State University Teaching Hospital, South-South, Nigeria
Journal of Advances in Medicine and Medical Research,
Background: Caesarean section (CS) is a major obstetric surgery done for pregnant women and is lifesaving.
Aim: The study was aimed at reviewing CS at the Rivers State University Teaching Hospital (RSUTH), to determine the prevalence, trend and indications, for improved management outcomes.
Methods: In this cross-sectional study, we reviewed five thousand, five hundred and ninety-eight (5598) cases of caesarean sections (3699 emergency, 1899 planned) managed at the RSUTH from 1st January, 2015 to 31st December, 2019. Data collected were analysed using IBM, Statistical Product and Service Solutions (SPSS), version 25.0 Armonk, New York.
Results: There were 13,516 deliveries and 5,598 cases of CS over the review period, giving the prevalence of CS as 41.4% or 414 per 1000 deliveries. Emergency and planned CS cases accounted for 66.1% and 33.9% respectively. An increasing trend of CS was observed over the review period. The mean age ± SD of the participants was 32.30±1.04 years (95% CI:30.26,34.34). Modal age group was 35-39 years, accounting for 33.2% followed by those aged 30-34 years (26.2%). Majority of the patients were multipara [3396 (60.7%)], married [4890 (87.4%)], Christians [5540 (99%)] and had tertiary level education [2800 (50%)]. The commonest indication for CS in RSUTH was previous caesarean section [1925(34%)], followed by cephalopelvic disproportion [757(13.4%)], foetal distress [418(7.4%)], preeclampsia [390(6.9%)] and multiple gestation [252 (4.5%)].
Conclusion: The rate of caesarean section is high in RSUTH with an increasing trend. Although CS is lifesaving, efforts should be made to reduce the rate to the level recommended by WHO, especially in Low-middle-income countries (LMICs), where there is high aversion to CS.
- Caesarean section
- Port Harcourt
- abdominal delivery.
How to Cite
Nwali MI. Caesarean section. In: Our Teachers-A Comprehensive Textbook of Obstetrics and Gynaecology. edn. Edited by Umeora OUJ, Egbuji CC, Onyebuchi AK, Ezeonu O. Abakaliki ST. Benedict Printing and Publishing. 2017;272-276.
Betrán AP, Ye J, Moller A-B, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: Global, regional and national estimates: 1990-2014. PloS one. 2016;11(2):e0148343.
Vogel JP, Betrán AP, Vindevoghel N, Souza JP, Torloni MR, Zhang J, Tunçalp Ö, Mori R, Morisaki N, Ortiz-Panozo E. Use of the Robson classification to assess caesarean section trends in 21 countries: A secondary analysis of two WHO multicountry surveys. The Lancet Global Health. 2015;3(5):e260-e270.
Betran AP, Ye J, Moller A-B, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Global Health. 2021;6(6):e005671.
Hafeez M, Yasin A, Badar N, Pasha MI, Akram N, Gulzar B. Prevalence and indications of caesarean section in a teaching hospital. JIMSA. 2014;27(1):15-16.
Akinola OI, Fabamwo AO, Tayo AO, Rabiu KA, Oshodi YA, Alokha ME. Caesarean section–an appraisal of some predictive factors in Lagos Nigeria. BMC Pregnancy and Childbirth. 2014;14(1):1-6.
Karlström A, Nystedt A, Johansson M, Hildingsson I. Behind the myth–few women prefer caesarean section in the absence of medical or obstetrical factors. Midwifery. 2011;27(5):620-627.
Betran A, Torloni MR, Zhang J, Gülmezoglu A, Section WWGoC, Aleem H, Althabe F, Bergholt T, de Bernis L, Carroli G. WHO statement on caesarean section rates. BJOG: An International Journal of Obstetrics & Gynaecology. 2016;123(5):667-670.
WHO WHO: World health statistics 2015: World Health Organization; 2015.
Betran AP, Torloni MR, Zhang J, Ye J, Mikolajczyk R, Deneux-Tharaux C, Oladapo OT, Souza JP, Tunçalp Ö, Vogel JP. What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. Reproductive Health. 2015;12(1):1-10.
Wekere FCC, Kalio DG, Kua PL, Iwo-Amah RS. Evaluating the relationship between socio-demographic factors, knowledge, ownership and usage of long-lasting insecticide-treated bed nets among pregnant mothers in Rivers State University Teaching Hospital. International Journal of Research and Reports in Gynaecology. 2020;1-12.
Rivers State, Nigeria Population statistics.
Wekere FCC, John DH, Clement-Wekere GA, Iwo-Amah RS. Prevalence, trend and outcome of twin pregnancy in Rivers State University Teaching Hospital, Southern Nigeria. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2021;10(7):2571-2578.
John C, Alegbeleye J. Caesarean delivery at a teaching hospital, south-south Nigeria: A five-year review. International Journal of TROPICAL DISEASE & Health. 2017:1-6.
Osegi N, Makinde OI. Towards optimizing caesarean section: A five-year review of caesarean sections at a Southern Nigeria hospital. International Journal of Reproduction Contraception, Obstet Gynecol. 2020;9(1):205-211.
Tsegaye H, Desalegne B, Wassihun B, Bante A. Prevalence and associated factors of caesarean section in Addis Ababa hospitals, Ethiopia. The Pan African Medical Journal. 2019;34.
Prah J, Kudom A, Afrifa A, Abdulai M, Sirikyi I, Abu E. Caesarean section in a primary health facility in Ghana: Clinical indications and feto-maternal outcomes. Journal of Public Health in Africa. 2017;8(2).
Gao Y, Xue Q, Chen G, Stone P, Zhao M, Chen Q. An analysis of the indications for cesarean section in a teaching hospital in China. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2013;170(2):414-418.
Osonwa O, Eko J, Ekeng P. Trends in caesarean section at Calabar general Hospital, Cross river state, Nigeria. Eur J Biol Med Sci Res. 2016;4(1):1-5.
Wekere FCC, Kua PL, Akani AB, Bademosi A. Prevalence, maternal and perinatal sequelae of antepartum haemorrhage in a tertiary hospital in South-South, Nigeria. International Journal of Clinical Obstetrics and Gynaecology. 2021;5(5):206-210.
Isah A, Adewole N, Zaman J. A five-year survey of cesarean delivery at a Nigerian tertiary hospital. Tropical Journal of Obstetrics and Gynaecology. 2018;35(1):14-17.
Nwobodo E, Isah A, Panti A. Elective caesarean section in a tertiary hospital in Sokoto, North Western Nigeria. Nigerian Medical Journal: Journal of the Nigeria Medical Association. 2011;52(4): 263.
Ijaiya M, Aboyeji P. Caesarean Delivery: The trend over a Ten-year period at Ilorin, Nigeria. Nigerian Journal of Surgical Research. 2001;3(1):11-18.
Iwo-Amah RS, Wekere FCC, Amadi SC, Kwosah JN. Emergency Caesarean section and its sequelae in a tertiary hospital in Niger Delta, Nigeria. Inter-national Journal of Reproduction Contraception, Obstet Gynecol. 2021; 10(12):4372-4376.
Onoh RC, Eze JN, Ezeonu PO, Lawani LO, Iyoke CA, Nkwo PO. A 10-year appraisal of cesarean delivery and the associated fetal and maternal outcomes at a teaching hospital in southeast Nigeria. International Journal of Women's Health. 2015;7:531.
Ugwu E, Obioha K, Okezie O, Ugwu A. A five-year survey of caesarean delivery at a Nigerian Tertiary Hospital. Annals of Medical and Health Sciences Research. 2011;1(1):77-84.
Eleje G, Udigwe G, Akabuike J, Eke A, Eke N, Umeobika J. The rate of Caesarean section in Nnewi, Nigeria: A 10-year Review. Afrimedic Journal. 2010;1(1):11-14.
Njoku C, Emechebe C, Edet E, Oyama S, Iklaki C. The trend, determinants and maternal outcome of caesarean section at The University of Calabar Teaching Hospital, Calabar, Nigeria; A 5 Year Appraisal. IOSR-JDMS. 2016;15(12):75-79.
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