Trends in caesarean section in Esut teaching hospital, Esuth, Parklane, Enugu, Nigeria: A five-year review

Background: Caesarean section, also known as caesarean delivery, is the surgical procedure, by which one or more babies are delivered through an incision in the mother’s abdomen. Caesarean section use continues to rise globally, now accounting for more than 21% of all childbirths. This work studied the trends of caesarean section in ESUT Teaching Hospital, Enugu, Nigeria. Aim: To review the trends of Caesarean section in ESUT Teaching Hospital, Enugu, Nigeria. Study design: This was a 5-year retrospective study of the trends of Caesarean section in ESUT Teaching Hospital, Enugu, Nigeria from 31st December, 2022 to 1st January, 2018. Methodology: This was a hospital based retrospective sytudy of all caesarean deliveries done in ESUT-TH Enugu from 31st December 2022 to 1s January 2018. The case notes from the medical records were reviewed and a total of 8,496 deliveries were recorded within the time under study. Out of this total 3,488 had caesarean delivery. The relevant data obtained from the case notes included age, educational level, occupation, religion, address, marital status, ethnicity, parity, booking status, indications for caesarean section, year of each caesarean section, and outcomes of the procedure. The total number of deliveries and number of caesarean sections, over the study period, were also obtained. Statistical analysis: These data were analyzed using Statistical Product and Service Solution (SPSS) version 25.0 to yield frequencies and percentages. The results were presented in tables. Result: Out of the 8496 deliveries, 3488 (41.05%) had Caesarean section, during the period. This gave a prevalence of 41.05% over the 5-year period. The lowest number of CS, 539(37.38%) was in 2021, while the highest number of CS 860(44.29%) occurred in the year 2019 without a definitive pattern of progression Most patients, that had CS were aged 27 to 37 years (51.5%), business women/traders(34.7%), Christians (92.2%), married (86.4%), Igbos (89.6%), and those who had secondary education (48.4%). The major indications of CS were fetal heart rate abnormalities 473(13.6%), previous uterine scars 452(12.96%) and obstructed labour 396(11.4%), while hand prolapse, suspected chorioamnionitis, non-reassuring biophysical profile and HELLP syndrome contributed the least. Conclusion: There were high rates of CS in ESUT-TH without any definitive progression pattern and the major indications were fetal heart rate abnormalities, previous uterine scars and obstructed labour.