Caesarean section and foetal outcome at Yekatit 12 Hospital, Addis Abeba, Ethiopia, 1987-1992.

This retrospective study was carried out to examine indications for Caesarean section (CS), foetal outcome and postoperative complications and to recommend ways of reducing maternal and neonatal deaths. In a five year period (September 1987 to August 1992), among 11,657 consecutive deliveries at Yekatit 12 Hospital, Addis Abeba, Ethiopia, there were 645 CSs, an overall CS rate of 5.5%. During this study, the indications for CS were cephalopelvic disproportion (31.2%), foetal distress (21.4%), previous CS (17.5%), placenta praevia (6.6%), cord prolapse (4.2%) and others (19.1%). There were 99 perinatal deaths, a gross perinatal mortality rate of 153.5 per 1,000 live births, which was a significantly higher rate than the total rate for all deliveries (67.5 per 1,000 live births, p < 0.01). There were seven maternal deaths (case fatality rate of 1.1%). The very high perinatal mortality in this study calls for a better and more effective antenatal service to improve foetal and maternal survival. This could be achieved by strengthening the referral system for pregnant women with obstructed and prolonged labour.