Trends in elective caesarean section rate in Aminu Kano Teaching Hospital, Kano: a four (4) year review

Ibrahim Adamu Yakasai¹* and Muhammed Yusuf Abubakar²

¹Senior Lecturer/Consultant, Bayero University Kano/ Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital Kano, Nigeria.

²Senior Registrar, Aminu Kano Teaching Hospital Kano, Nigeria.

*Corresponding Author E- mail: ibrahimyakasai57@hotmail.com  

Accepted 07 April, 2014

Abstract

Caesarean section (CS) is increasingly used for safe delivery for fetal or maternal indications either as an elective or emergency. The procedure is increasingly been used for delivery even in the developing countries due to the relative safety of blood transfusion services, improved anaesthesia, aseptic techniques and the availability of potent antibiotics. Elective caesarean sections have been pronounced safer for both the mother and the fetus in terms of adverse events compared to emergency caesarean sections. Paradoxically, emergency caesarean sections continue to form the bulk of caesarean deliveries in our facility. Although the study has shown a steady increase in elective CS rate, probably due to increased cohort of patients with 2 or more caesarean sections, increased utilization of CS for breech presentations in primigravidae at term and for women with bad obstetric history. The aim of this study was to determine the trends in caesarean section rates. This was a retrospective study of the clinical records of all patients that had Caesarean Section in Aminu Kano Teaching Hospital, Kano from January 2006 to December 2009, a 4 year period. Data on the number and type of Caesarean Section, age of patients and the indication for the Caesarean Section were extracted and analyzed. There were total of 14,570 deliveries at the facility over the period of the study, out of which 2,519 were caesarean sections giving a caesarean section rate of 17.3%. Of all the patients that had caesarean sections, 2,131 (84.6%) were emergency caesarean section, while 388 (15.4%) were elective caesarean sections. There was a steady increase in elective caesarean section rate from 12.4% in 2006 to 18.5% and 17.1% in the last two years of the study period respectively. Repeat caesarean sections following two or more previous caesarean sections were the commonest indication for the elective caesarean section accounting for 51.3% of all cases, followed by bad obstetric history and abnormal presentations/ lie accounting for 11.5% and 10.3% of cases respectively. The caesarean section rate in our centre was 17.1% and there is a rising trend of elective caesarean section in our centre accounting for 1 out of every 6 caesarean sections. The commonest indication for elective caesarean section was two or more previous caesarean sections.

Keywords: Elective, emergency, caesarean section, outcome.