Cesarean section at the Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, northeast Nigeria: a 3-year retrospective review

Abstract

Cesarean section is the most common major surgical procedure in obstetrics, and its rate has increased globally in recent years. The aim of the study was to determine the incidence, indications, maternal/perinatal outcome, and complications of cesarean section in the Abubakar Tafawa Balewa University Teaching Hospital Bauchi (ATBUTH), Bauchi, Nigeria. The study reviewed all cesarean sections performed between July 1, 2016, and June 30, 2019. Case notes of patients and records from the labor ward, theater, and special care baby unit were used to obtain data, which included age, parity, booking status, type of cesarean section, maternal morbidity and mortality, and the perinatal outcome. Analysis was done using SPSS version 21, and data was presented in tables and charts in addition to ratios, proportions, and percentages. A total of 10,705 deliveries were conducted during the review period, of which 3,380 were cesarean births, given a cesarean section rate of 31.57%. Emergency cesarean sections accounted for 67.72%, and 81.39% of all the sections were primary cesarean sections. Only 3,501 parturients (32.70%) were booked. Hypertensive Disorders of Pregnancy (HDP), 733 (29.17), were the most common indication for the operation, followed by repeat cesarean section, 373(25.37%). About 87.86% of the fetuses were delivered alive, while 12.14% were stillborn and had an early neonatal death. Anemia was the most common postoperative complication seen in 13% of the women who had a cesarean delivery. The most debilitating complication was vesicovaginal fistula which occurred in eight patients (0.24%). The maternal mortality and perinatal mortality rates were 580/100,000 live births and 121.42/1000 babies, respectively, during the review period. The study showed a high rate of cesarean section in ATBUTH. The commonest indication was HDP, and anemia was the significant post-operative complication.