ASSESSMENT OF LEADING INDICATION AND OUTCOME OF CESAREAN DELIVERY IN ARBA MINCH GENERAL HOSPITAL. SOUTHERN ETHIOPIA

Abstract

ABSTRACT Background: Maternal mortality rate in Ethiopia is 420/100000 live birth, which makes our country one of the six countries contributing 50% of maternal death in the globe. Among the cause of death obstructed labor and its complication has significant figure. Despite this, Ethiopia has low institutional delivery rate and cesarean section rate, 10% and <2% respectively. This figure varies from region to region, rural to urban setting and also among institutions. The reason for the variations in those institutions is not adequately studied. To Assess the main indications and outcome of cesarean section in Arbaminch General Hospital, Ethiopia. Subjects and Methods: A retrospective review of caesarean section performed at AGH 2007 E.C. inclusive ALL women of any age and parity who underwent the caesarean section were included. . While the cases with normal and operative vaginal deliveries and cases of rupture uterus were excluded. Data on rate and indications of caesarean section were extracted from operation room registers, anesthesia sheets, delivery room and discharge registers were reviewed and analyzed on spss version 16.0. Result: During the study period, there were a total of 3195, deliveries out of which 546, were cesareans deliveries giving ceserean section rate of 17% Most of the rates are between the recommended ranges and no significant change in the pattern of indications observed. Conclusion and Recommendation: the cesarean section rate in our society is in the acceptable range and the trend is also in the same pattern. The leading indications are also the leading cause of death as in national figure, which can be reduced by The leading primary indications were NRFHRP 22% (120) , cephalopelvic disproportion(CPD) 18.5% (101), previous one CS 14.5% (79), multiple pregnancy account 7.3% (40) obstructed labor 7% (38) ante partum hemorrhage 6.6% (36), abnormal pattern of labor 5.8% (32), failed induction 5.1% (28) two previous scar 4% (22) , prolonged latent with grade 3 MSAF 3.8% (21) footling breech presentation 2.9 % (16) cord presentation 2.2% (12) and others account for 2% (11). Conclusion and Recommendation: the cesarean section rate in our society is slightly above the acceptable range . The leading indications are also the leading cause of death as in national figure, which can be reduced by different measures. Starting from the government down to individual level in joint with NGOs should work to reduce the high mortality rate, to raise the low institutional delivery, to maintain the institutional CSR and to reduce the causes for maternal and perinatal morbidity and mortality including inappropriate cesarean sections and its consequences.