A 4-year analysis of caesarean delivery in a Nigerian teaching hospital: one-quarter of babies born surgically.

Between January 2001 and December 2004, a total of 2,922 deliveries were conducted at the University of Nigeria Teaching Hospital , Enugu. Caesarean section accounted for 740 deliveries, an incidence of 25.3%. A total of 62.2% of caesarean sections were done as emergencies, while 37.8% were done as elective procedures and 64.8% were booked patients. Repeat caesarean sections accounted for 59.2% of elective cases and 18.7% of emergency cases. Fetal distress was responsible for 11. 6% of emergency cases, however 35.6% of babies delivered for clinically diagnosed fetal distress had Apgar scores 7 and above. A total of 85.6% of patients were between 25 - 29 years of age; 31% were primigravida, while 54.4% were Gravida 2 - 4. There were seven (0.6%) maternal deaths and 73 (9.2%) stillbirths. It was concluded that reduction of primary caesarean section rate and repeat caesarean rates should be the main target of any strategy to reduce caesarean section rate. Other measures to reduce the caesarean section rate and recommendations are discussed.