Document Detail


Rising trend and indications of caesarean section at the university of Maiduguri teaching hospital, Nigeria.
MedLine Citation:
PMID:  19805945     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the trend and indications for the use of caesarean delivery in our environment. METHOD: A retrospective review of the caesarean sections performed at University of Maiduguri Teaching Hospital from January 2000 to December 2005 inclusive. RESULTS: During the study period, there were 10,097 deliveries and 1192 caesarean sections giving a caesarean section rate of 11.8%. The major maternal indications were cephalopelvic disproportion (15.5%), previous caesarean section (14.7%), eclampsia (7.2%), failed induction of labor (5.5%), and placenta previa (5.1%). Fetal distress (9.6%), breech presentation (4.7%), fetal macrosomia (4.3%), and pregnancy complicated by multiple fetuses (4.2%) were the major fetal indications. The caesarean section rate showed a steady increase over the years (7.20% in 2000-13.95% in 2005), but yearly analysis of the demographic characteristics, type of caesarean section, and the major indications did not reveal any consistent changes to account for the rising trend except for the increasing frequency of fetal distress as an indication of caesarean section over the years, which was also not statistically significant (c[2] =8.08; P=0.12). The overall perinatal mortality in the study population was found to be 72.7/1000 birth and despite the rising rate of caesarean section, the perinatal outcomes did not improve over the years. CONCLUSION: Trial of vaginal birth after caesarean section in appropriate cases and use of cardiotocography for continuous fetal heart rate monitoring in labor with confirmation of suspected fetal distress through fetal blood acid--base study are recommended. A prospective study may reveal some of the other reasons for the increasing caesarean section rate.
Authors:
Ado D Geidam; Bala M Audu; Bello M Kawuwa; Jessy Y Obed
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of African medicine     Volume:  8     ISSN:  1596-3519     ISO Abbreviation:  Ann Afr Med     Publication Date:    2009 Apr-Jun
Date Detail:
Created Date:  2009-10-06     Completed Date:  2010-01-13     Revised Date:  2010-06-10    
Medline Journal Info:
Nlm Unique ID:  101231417     Medline TA:  Ann Afr Med     Country:  Nigeria    
Other Details:
Languages:  eng     Pagination:  127-32     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital Maiduguri, Borno, Nigeria. adogeidam@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Breech Presentation
Cephalopelvic Disproportion
Cesarean Section / statistics & numerical data*,  trends
Decision Making
Eclampsia
Female
Fetal Distress
Fetal Macrosomia
Hospitals, Teaching / statistics & numerical data*,  trends
Humans
Middle Aged
Multiple Birth Offspring
Nigeria
Parity
Placenta Previa
Pregnancy
Pregnancy Outcome
Retrospective Studies
Risk Assessment
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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