title: A 10-year appraisal of cesarean delivery and the associated fetal and maternal outcomes at a teaching hospital in southeast Nigeria.
abstract: BACKGROUND
  The global rise in cesarean delivery rate has been a major source of public health concern.
  
  
  OBJECTIVE
  To appraise the cesarean deliveries and the associated fetal and maternal outcomes.
  
  
  METHODS
  The study was a case series with data collected retrospectively from the records of patients delivered by cesarean section at the Ebonyi State University Teaching Hospital, Abakaliki over a 10-year period, from January 2002 to December 2011. Ethical approval was obtained.
  
  
  RESULTS
  Of 14,198 deliveries, 2,323/14,198 (16.4%) were by cesarean deliveries. The overall increase of cesarean delivery was 11.1/10 (1.1%) per annum from 184/1,512 (12.2%) in 2002 to 230/986 (23.3%) in 2011. Of 2,097 case folders studied, 1,742/2,097 (83.1%) were delivered at term, and in 1,576/2,097 (75.2%), the cesarean deliveries were emergencies. The common indications for cesarean delivery were previous cesarean scars 417/2,097 (19.9%) and obstructed labor 331/2,097 (15.8%). There were 296 perinatal deaths, giving a perinatal mortality rate of (296/2,197) 134.7/1,000 births. Also, 129/2,097 (6.1%) maternal case fatalities occurred, giving a maternal mortality rate of 908.6/100,000 total births. Hemorrhage 57/129 (44.2%) and sepsis 41/129 (32.6%) were the major causes.
  
  
  CONCLUSIONS
  The study recorded a significant increase in cesarean delivery rate. Previous cesarean scars and obstructed labors were the main indications. Perinatal and maternal case fatalities were huge. Hence, there is need for continued community education for its reduction.
authors.affiliation: Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Abakaliki, Nigeria.
authors.forename: Robinson Chukwudi
authors.initials: RC
authors.lastname: Onoh
authors.affiliation: Department of Obstetrics and Gynaecology, College of Health Sciences, Ebonyi State University, Abakaliki, Nigeria.
authors.forename: Justus Ndulue
authors.initials: JN
authors.lastname: Eze
authors.affiliation: Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Abakaliki, Nigeria.
authors.forename: Paul Olisaemeka
authors.initials: PO
authors.lastname: Ezeonu
authors.affiliation: Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Abakaliki, Nigeria.
authors.forename: Lucky Osaheni
authors.initials: LO
authors.lastname: Lawani
authors.affiliation: Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
authors.forename: Chukwuemeka Anthony
authors.initials: CA
authors.lastname: Iyoke
authors.affiliation: Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
authors.forename: Peter Onubiwe
authors.initials: PO
authors.lastname: Nkwo
keywords: case fatality; cesarean delivery rate; hemorrhage; previous scar; unbooked