title: Elective caesarean section in a tertiary hospital in Sokoto, north western Nigeria.
abstract: BACKGROUND
  Elective caesarean sections have been considered safer for both mother and the fetus compared to their emergency counterpart. However, emergency caesarean sections have continued to form bulk of caesarean deliveries in our facility.
  
  
  OBJECTIVE
  The objective of this study was to determine the caesarean section rate together with the trend, indications, and maternal mortality associated with elective caesarean operation.
  
  
  METHODS
  A retrospective analysis of clinical records of all the patients that had caesarean section between January 2002 and December 2010 (9 years) at Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, Nigeria was conducted.
  
  
  RESULTS
  During the 9 year study period, 2284 caesarean sections were performed out of 22,985 total deliveries at UDUTH Sokoto, thus giving a caesarean section rate of 9.9%. Emergency and elective operations accounted for 1784 (78.2%) and 498 (21.8%) of the cases respectively. The rate of elective caesarean section increased from 1.7% in 2002 to 3.2% in 2007. Thereafter it declined gradually to 1.8% in 2010. Repeat caesarean section (30.7%) and malpresentation (17.1%) were the most common indications for elective caesarean operation. There were 18 maternal deaths from caesarean section and only one from the elective caesarean procedure.
  
  
  CONCLUSIONS
  The rising trend in the elective caesarean section rate in this study underscores the need for better and improved patient selection together with counseling on its benefits and risks. This is because despite the fact that it is safer than emergency caesarean operation, it is not entirely devoid of complications. Routine use of spinal anesthesia in performing the procedure should be encouraged.
authors.affiliation: Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University Teaching Hospital Sokoto, Nigeria.
authors.forename: E I
authors.initials: EI
authors.lastname: Nwobodo
authors.forename: A Y
authors.initials: AY
authors.lastname: Isah
authors.forename: A
authors.initials: A
authors.lastname: Panti