Fetal outcome following cesarean section in a university teaching hospital.

Objective: To evaluate fetal outcome for the various indications for cesarean section.

Methodology: A review of all cases of cesarean section that were done in the maternity unit at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, between January 2006 and April 2007, with emphasis on indications and perinatal outcome.

Results: There were 2562 total deliveries within the study period and 112 perinatal deaths giving a perinatal mortality rate of 43.7 per 1000 live births. Cesarean section accounted for 216 of the deliveries (8.4%) with 24 perinatal deaths (11.1%). Perinatal mortality from Cesarean sections accounted for 21.4% of the total deaths with severe birth asphyxia responsible for most perinatal deaths, 17 of 24 (70.8%). There were 174 emergency sections with 22 perinatal deaths, while 42 elective sections had 2 perinatal deaths. The main indications for cesarean section were cephalopelvic disproportion, 86 (39.8%); previous section plus an obstetric abnormality, 39 (18.1%); and prolonged obstructed labor, (10.2%), with perinatal deaths of 3, 2 and 1, respectively.

Conclusions: The perinatal mortality among the cesarean deliveries were 11.1%, and the main cause of death was severe birth asphyxia. Emergency cesarean section was more likely than elective to result in a perinatal loss. The indication with the poorest fetal outcome was prolonged obstructed labor.