Emergency caesarean section in a Nigerian tertiary health centre

Caesarean delivery is an important aspect of emergency obstetric care and a major tool in the reduction of maternal and perinatal morbidity and mortality This study was done to determine the caesarean section rate, ascertain the trend of emergency caesarean section, indications for emergency caesarean section and emergency caesarean morbidity and mortality at the Federal Medical Centre Makurdi.

A retrospective analysis of the clinical records of all patients delivered by caesarean section between January 2004 and December 2006 at the Federal Medical Centre Makurdi in north central Nigeria was conducted.

There were 4011 deliveries with 420 caesarean sections during the review period giving a caesarean section rate of 10.5%. Emergency caesarean sections accounted for 351 (83.6%) caesarean deliveries. The rate of emergency caesarean section decreased from 89.7% in 2004 to 77.2% in 2006. The leading indication for emergency caesarean section was cephalopelvic disproportion, accounting for 138 (39.3%) cases, while antepartum haemorrhage and foetal distress followed in that order. There were 9 maternal deaths associated with emergency caesarean section giving a caesarean mortality rate ofs 2.1%

Emergency caesarean sections account for 5 out of every 6 caesarean deliveries in our centre with a decreasing trend relative to elective caesarean sections. The emergency caesarean mortality is high.