Igberase G O, Ebeigbe P N, Andrew B O
Department of Obstetrics and Gynaecology, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria.
Niger J Clin Pract. 2009 Sep;12(3):294-7.
Caesarean section rate is rising worldwide and Nigeria is no exception.
This was a descriptive study. The data from case notes, antenatal and theatre records of patients who had caesarean delivery over a ten year period in the Baptist medical center, Eku were extracted and analysed.
The total delivery for the period under study was 5,153 and the total number of caesarean deliveries was 1,777 giving a caesarean section rate of 34.5%. There was no definite trend in the yearly caesarean section rates. Majority of the cases were aged 25-29 (32%). Grandmultipara constituted 26.4% of the patients while 70.1% of cases presented at a gestational age range of 37-42 weeks. Majority of the patients (59.5%) where unbooked for antenatal care. Dystocia (27.1%) was the commonest indication for caesarean section. Emergency abdominal delivery constituted 63.3% of cases while the common complications included wound breakdown, anaemia and endometritis. There were a total of 25 maternal deaths giving a case fatality rate of 1.4%. The leading causes of deaths were haemorrhage (36%), infections (24%), severe preeclampsia/eclampsia (24%), cardiac arrest (12%) and anaesthesia related complication (4%).
This study found a very high caesarean section rate with majority of cases presenting as unbooked emergency cases. High caesarean section rate in this region was due to increase in primary caesarean delivery for dystocia, elective repeat caesarean deliveries and caesarean deliveries for preeclampsia/eclampsia. Future studies should be extended to rural areas and be targeted at determining whole population Caesarean section rates.
剖宫产率在全球范围内呈上升趋势，尼日利亚也不例外。
这是一项描述性研究。从埃库浸信会医疗中心10年间剖宫产患者的病历、产前记录和手术记录中提取数据并进行分析。
研究期间的总分娩数为5153例，剖宫产总数为1777例，剖宫产率为34.5%。年度剖宫产率没有明确趋势。大多数病例年龄在25 - 29岁（32%）。经产妇占患者的26.4%，70.1%的病例孕周在37 - 42周。大多数患者（59.5%）未进行产前检查。难产（27.1%）是剖宫产最常见的指征。急诊剖宫产占病例的63.3%，常见并发症包括伤口裂开、贫血和子宫内膜炎。共有25例孕产妇死亡，病死率为1.4%。死亡的主要原因是出血（36%）、感染（24%）、重度子痫前期/子痫（24%）、心脏骤停（12%）和麻醉相关并发症（4%）。
本研究发现剖宫产率非常高，大多数病例为未预约的急诊病例。该地区剖宫产率高是由于难产的首次剖宫产、选择性再次剖宫产以及子痫前期/子痫的剖宫产增加。未来的研究应扩展到农村地区，并旨在确定全人群的剖宫产率。
