Emergency caesarean deliveries: Analysis of 592 cases in federal medical centre Keffi, North Central Nigeria

Abstract

Background: Life threatening obstetric conditions often requires prompt interventions especially by caesarean delivery which in itself is associated with immediate and long term risks to mothers and babies. This study aimed at determining emergency caesarean section rate, its indications, morbidities as well as maternal and fetal outcomes in our clinical setting. Materials and Methods: This was a prospective analysis of all the patients delivered by emergency cesarean section between January 1st 2016 and 31st December 2017 at the Federal Medical Centre Keffi, Nasarawa state, Nigeria. Data was collected from the case files of the patients after discharge from the postnatal ward and documented in a pre-tested proforma. Analysis was done by simple percentages using SPSS version 20. Results: A total of 2958 deliveries took place during the period study out of which 592 emergency cesarean sections (CS) were performed. Emergency CS accounted for 20.0% of all deliveries. About 62.3% (369/592) of the patients were unbooked for antenatal care. The most common indication for emergency caesarean section was obstructed labour due to cephalopelvic disproportion, accounting for 212 (35.8%) of cases. Others included antepartum hemorrhage, fetal distress, and severe preeclampsia/eclampsia. Morbidities associated with emergency cesarean deliveries included post-operative site infection, puerperal sepsis, postpartum haemorrhage and obstetric fistula. There were one (0.2%) maternal and 23 (3.8%) perinatal mortalities. Conclusion: Emergency cesarean section rate is relatively high in this centre mostly among un-booked patients. There is need to increase effective antenatal care coverage and skilled delivery in rural areas to avert potential obstetric consequences of this procedure among women.