Prevalence and outcome of ceasarean-section in attat hospital gurage zone, snnpr, Ethiopia

Abstract

Background: Cesarean-delivery has played a major role in lowering both maternal and perinatal morbidity and mortality rates. Rates of cesarean section are of concern to both developed & developing countries. The global cesarean delivery rate is distributed very unevenly and results 15 % of abdominal delivery. The rate ranges 2% in least developed countries to 21.1% in developed countries. The four most common indications for cesarean delivery which account for approximately 80 percent of these deliveries include: failure to progress during labor, previous hysterectomy, nonreassuring fetal status and fetal malpresentation. Complications and consequences associated with CS include infectious and noninfectious complications. Objective: To determine the prevalence, common indications, outcomes and complications of cesarean section in Attat Hospital. METHODES: Facility based cross-sectional study was conducted in Attat Hospital, Gurage zone SNNPR, Ethiopia from January/2011 –December/2013GC. Data was collected using structured questionnaire by trained data collectors. The collected data was checked for their completeness, entered, edited, cleaned and analyzed by SPSS Verssion20.Chi- square test, 95% CI and P-value <0.05 were used to examine association between dependent and independent variables. Result: The prevalence of cesarean section is 27.6%. The age of the patients ranged between 16- 45years with a mean age of 28.12 years (SD±5.14). The leading indications for cesarean birth were, Cephalopelvic disproportion (CPD) (38.1%), previous CS (18.9%), fetal distress (12.5%), malpresentation and malposition (7.1%), and antepartum hemorrhage (APH) (6%) accounting for 82.6% of the indications for cesarean section. Maternal indications constituted 191 (68%) whereas fetal indications accounted for 90 (32%). There was only one (0.4%) maternal death, but the overall maternal morbidity rate was 9.6%. The gross perinatal mortality rate was 64/1000 live births which was statistically higher than 2011 national report for all deliveries, which was 46/1000 live births. Conclusion: Although the Cs rate of 27.6% is high, the perinatal outcome was not improved. Cesarean sections performed for appropriate medical or obstetric indications are life saving for both the mother as well as the new born. Therefore to reduce the high prevalence of Cs, each case should be thoroughly evaluated to determine the possibility for vaginal delivery.