INDICATION AND OUTCOME OF CESAREAN DELIVERY IN PUBLIC HEALTH FACILITIES OF ADDIS ABABA, ETHIOPIA, A CROSS SECTIONAL STUDY

Abstract

Background: Cesarean delivery (CD) is defined as the birth of a fetus, placenta or membrane from the uterus through an abdominal incision after 28 weeks of gestation. Lifesaving interventions can be used for mothers and babies when vaginal delivery is contraindicated. If not medically indicated or if performed under suboptimal conditions, CD can cause maternal and fetal complications.

Objective: This study aimed to assess the indication and outcome of CD and associated factors for cesarean delivery in Addis Ababa, Ethiopia.

Methods: An institutional-based cross-sectional study was performed. A total of 422 CDs from Yekatit 12 Hospital Medical College, Janmeda Health Center and Kotebe Health Center were included in the study. Mothers and newborns were followed for the first seven days of life, at the time of discharge, or at the time of death; whichever came first was considered the last time of data collection. The statistical analysis was carried out using SPSS version 25. Descriptive statistics are presented as frequencies. A chi-square test was performed to evaluate the relationships between the dependent and independent variables. A P value of less than 0.05 was considered to indicate statistical significance.

Results and Conclusion: Emergency CD accounts for 75.4% of the total cesarean deliveries. From clinical indications, a nonreassuring fetal heart rate pattern was the most common indication, followed by cephalopelvic disproportion. Nearly six(5.9)% of mothers had maternal complications. Repeat CD, emergency CD and mothers with antepartum hemorrhage were shown to be associated with maternal complications. The neonatal death rate was 3%. Nulliparity, hypertensive disorder during pregnancy, gestational age, the APGAR score and the need for immediate neonatal resuscitation were found to be significantly associated with neonatal death.

Keywords: delivery, cesarean delivery, outcome, indication, maternal complication, neonatal death