A 10-year appraisal of cesarean delivery and the associated fetal and maternal outcomes at a teaching hospital in southeast Nigeria

Figures & data

Figure 1 Annual cesarean delivery rate over a 10-year period 2002–2011 at EBSUTH.

Abbreviation: EBSUTH, Ebonyi State University Teaching Hospital.

Table 1 Trend of cesarean delivery over a 10-year period 2002–2011 at EBSUTH

Years	Total deliveries	Number of cesarean deliveries, N (%)	Perinatal mortality rate,a N (×1,000 births)
2002	1,512	184 (12.2)	56 (37.0)
2003	1,722	243 (14.1)	68 (39.5)
2004	2,325	363 (15.6)	54 (27.5)
2005	1,728	305 (17.7)	138 (79.9)
2006	1,550	242 (15.6)	90 (58.1)
2007	1,228	231 (18.8)	119 (96.9)
2008	1,189	245 (20.6)	78 (65.6)
2009	1,196	154 (12.9)	70 (88.5)
2010	762	126 (16.5)	61 (80.0)
2011	986	230 (23.3)	88 (89.2)
2002–2011	14,198	2,323 (16.4)	822 (57.9)
Chi-square test for the comparisons
Comparison of 2002 and 2011
2002	1,512	184 (12.2)	<0.001
2011	986	230 (23.3)
Comparison of 5-year interval
2002–2006	8,837	1,337 (15.1)	<0.001
2007–2011	5,361	986 (18.4)

Note:

a Perinatal mortality rate means fetal death from age of viability to 1 week postdelivery per 1,000 births.

Abbreviation: EBSUTH, Ebonyi State University Teaching Hospital.

Table 2 Main characteristics of 2,097 cases of cesarean delivery performed at EBSUTH over a 10-year period (2002–2011)

Item	N (%) (N=2,097)	Range	Mean (± SD)
Age (years)
≤19	107 (5.1)
20–24	444 (21.2)	16–43	27.4 (±4.9)
25–29	872 (41.6)
30–34	600 (28.6)
≥35	74 (3.5)
Parity
0	608 (29.0)
1–4	1,122 (53.5)	0–11	2.2 (±2.1)
≥5	367 (17.5)
Booking status
Booked	1,249 (59.7)
Unbooked	848 (40.3)
Gestational age at delivery (weeks)
<37 (preterm)	165 (7.9)
37 to <42 (term)	1,742 (83.1)
≥42 (postterm)	190 (9.0)
Nature of CS
Emergency	1,576 (75.2)
Elective (all booked)	521 (24.8)

Abbreviation: EBSUTH, Ebonyi State University Teaching Hospital; CS, Cesarean section; SD, standard deviation.

Table 3 The indications for the cesarean deliveries in 2,097 cases delivered at EBSUTH over a 10-year period (2002–2011)a

Indications	N (%)
Previous cesarean scar	417 (19.9)
Obstructed labor	331 (15.8)
Poor progress/prolonged in labor	236 (11.3)
Fetal distress	219 (10.4)
Cephalopelvic disproportion	173 (8.2)
Hypertensive diseases in pregnancy	162 (7.7)
Breech presentation	150 (7.2)
Placenta previa	137 (6.5)
Transverse lieb	122 (5.8)
Multiple pregnancy	99 (4.7)
Cord prolapse	55 (2.6)
Precious pregnancy	52 (2.5)
Fetal macrosomiac	25 (1.2)
Postterm pregnancy	20 (1.0)
Previous VVF repair	8 (0.4)
Uterine fibroids	4 (0.2)
Intrauterine growth restriction	4 (0.2)
Premature rupture of membranes	4 (0.2)
Retained second twin	4 (0.2)
Fetal anomaly	4 (0.2)
Placental abruption	3 (0.14)
Preterm pregnancies	3 (0.14)
Cervical cancer	1 (0.05)
Vulval warts	1 (0.05)

Notes:

a Multiple entries were allowed.

b Shoulder presentation and if neglected could lead to hand prolapse (neglected transverse lie).

c Fetal weight of ≥4.0 kg.

Abbreviations: EBSUTH, Ebonyi State University Teaching Hospital; VVF, vesicovaginal fistula.

Table 4 Outcome of 2,097 cesarean deliveries performed over a 10-year period (2002–2011) at EBSUTH

Characteristics	N (%)
Sex
Male	1,272 (57.9)
Female	925 (42.1)
Weight (g)
≤2,499	408 (18.6)
2,500–3,999	1,667 (75.9)
4,000–4,499	97 (4.4)
≥4,500	25 (1.1)
Apgar scores	1st minute
7–10	1,253 (57.0)
1–6	663 (30.2)
0	281 (12.8)
Apgar scores	5th and 10th minutes
7–10	1,668 (75.9)
1–6	233 (10.6)
0	296 (13.5)

Abbreviation: EBSUTH, Ebonyi State University Teaching Hospital.

Table 5 Intraoperative blood loss, frequency of blood transfusion, maternal case fatality, and causes of maternal death among mothers delivered by cesarean delivery over a 10-year period 2002–2011 at EBSUTH

Outcome	N (%) (N=2,097)
Intraoperative blood loss (mL)
<500	1,042 (49.7)
500–1,000	975 (46.5)
>1,000	80 (3.8)
Frequency of blood transfusion (units of blood)
≤2	847 (40.4)
≥3	135 (6.4)
Total	982 (46.8)
Maternal case fatality associated with cesarean section	129 (6.1%)
Causes of maternal death (some had multiple causes)
Hemorrhage and severe anemia	57 (44.2)
Overwhelming infection	41 (32.6)
Hypertensive diseases	39 (30.2)
Cause of death uncertain	14 (10.9)

Abbreviation: EBSUTH, Ebonyi State University Teaching Hospital.