Cesarean section prevalence, indications and management outcome in metu karl hospital, illu aba bora zone, oromiya south west Ethiopia.

Abstract

ackground: - Cesarean section is a term commonly used in obstetrics to describe the delivery of a viable fetus through an incision on the abdominal wall and the uterus. WHO considers 5–15% Cesarean section rates of to be the optimal. However, access to safe Cesarean section estimated at 1–2% in sub-Saharan Africa. Four indications for cesarean delivery account for 90% of the dramatic increase in this procedure over the past forty years: dystocia, repeat cesarean section, breech presentation, and fetal distress . Objective: - To determine cesarean section prevalence, indications and management outcome in MKH from Mar.1- Aug.30, 2013. Methods: - Hospital based retrospective cross-sectional record review was conducted. Data were collected using structured checklist and all the cesarean delivery from Mar. 1 to Aug.30, 2013 were included in the study .Analysis was made using SPSS v. 16.0 and associations was made using binary logistic regression; the result displayed using statistical tables. Results: - In the retrospective study done in Metu Karl Hospital, there were 1023 total deliveries out of which 186 of them were delivered by cesarean section making the prevalence of 18.2% and 75.8% of the women have ages ranging from 20-29years and 71% were from rural area with 53.8% para one and 83.9% were term with GA of 38-42 weeks with 80.1% having ANC follow up from different health institution. C/S was done on emergency base in 96.2% of women who undergone C/S and 52.2% have weight of >=3.5kg and 95.5% have normal APGAR score and the four main indications for C/S were CPD(44.1%), non reassuring fetal heart rate pattern(18.3%), malpresentations(14.5%), and repeated cesarean section(12.4 %) contributing for 89.3% of indications and complication seen in 21(11.3%) of women in the study populations; i.e. wound site infection(42.9%), puerperal sepsis(19.0%), hemorrhage(23.8%), death(4.8%) and others(9.5%) and cause of death was anesthesia complication. 8(4.3%) were new born with bad fetal outcome with 6(75%) of them were still birth and 2(25%) were early neonatal death with perinatal mortality rate of 43/1000 live birth. Conclusion The cesarean prevalence in this study was 18.2% and the most common indication was cephalopelvic disproportion(44.1%) and bad maternal and fetal outcome were 21(11.3%) and 8(4.3%) respectively with perinatal mortality rate of 43/1000 live births.