title: Caesarean section and perinatal outcomes in a sub-urban tertiary hospital in North-West Nigeria.
abstract: OBJECTIVE
  This study was undertaken to review the caesarean section rate and perinatal mortality in Federal Medical Centre, Birnin Kudu from 1(st) January 2010 to 31st December, 2012.
  
  
  METHODS
  This was a retrospective study involving review of 580 case files. Ethical clearance was obtained. The records of labour ward, neonatal intensive care unit (ICU) and operating theatre were use. Information extracted includes age, parity, booking status, total deliveries, indications for caesarean section and perinatal outcome from 1(st) January 2010 to 31(st) December 2012 at Federal Medical Centre, Birnin Kudu. The data obtained was analysed using SPSS version 17.0 statistical software (Chicago, Il, USA). Absolute numbers and simple percentages were used to describe categorical variables. Association between caesarean section and perinatal mortality was determined using Pearson's Coefficient of correlation and student t- test. P - value < 0.05 was considered statistically significant.
  
  
  RESULTS
  This study reported a caesarean section rate of 17.69 % and a perinatal mortality rate of 165.6 per 1000. Majority of the babies (78.2%) were within normal weight. The mean age of the women was 25.9 ± 6.2 years and mean parity was 4 ± 3. Majority of them were uneducated and unemployed. Obstructed labour was the commonest indication for emergency caesarean section accounting for 31.7% of caesarean sections and foetal distress was the least at 2.6 %. Two or more previous caesarean section was the commonest indication for elective caesarean section (17.1%) and bad obstetrics history the least indication (1.4%). There is a weak positive correlation (r = 0.35) between caesarean section rate and perinatal mortality and this association was not statistically significant (P = 0.12).
  
  
  CONCLUSIONS
  Caesarean section and perinatal mortality rates in the present study are comparatively high. Absence of significant correlation means that a high caesarean section rate is not likely to improve perinatal outcomes in babies of normal weight; therefore the caesarean section rate in this centre should be reduced. Measures to reduce perinatal mortality such as skilled attendant in labour and training of medical staff in neonatal resuscitation should be adopted.
authors.affiliation: Department of Obstetrics and Gynaecology, Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Ugwa
authors.affiliation: Department of Obstetrics and Gynaecology, Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria.
authors.forename: Adewale
authors.initials: A
authors.lastname: Ashimi
authors.affiliation: Department of Obstetrics and Gynaecology, Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria.
authors.forename: Mohammed Yusuf
authors.initials: MY
authors.lastname: Abubakar
keywords: Caesarean section; north-west Nigeria; perinatal outcomes