Publication:

Pattern of primary caesarean deliveries in a Nigerian tertiary hospital

Background Primary caesarean section (CS) has become a major driver of the steadily rising total caesarean rate. This study determined the primary CS rate, pattern and associated factors.

Methods It was a retrospective, hospital-based cross-sectional study of 645 pregnant women who had primary caesarean section over a 3-year period in Lagos state university teaching hospital, Lagos, Nigeria. Data obtained were expressed in frequency and percentages.

Results Primary CS accounted for more than 50% of all the CS done during the study period with a primary CS rate of 16.7% and total CS rate was 30.6%. Primary CS was commonest among women of age group 30-39years (50.1%) and women with no prior parous experience (58.6%). The commonest indication for primary CS was poor progress in labour due to cephalopelvic disproportion, which occurred in 170 women (26.4%), followed by suspected foetal distress in 94 women (14.6%) and hypertensive disease in pregnancy in 91 women (14.1%). Post-operative wound infection and/or dehiscence was the most prevalent post-operative complication occurring in 12.1% of women who had primary CS.

Conclusions Primary CS rate is increasing and relatively more common among primiparous women. Cephalopelvic disproportion, suspected foetal distress and hypertensive disorders of pregnancy are the leading indications for primary CS.