Caesarean morbidity and mortality at Maiduguri, Nigeria.

A total of 2456 deliveries took place at the University of Maiduguri Teaching Hospital, Maiduguri, between January 1995 and December 1996 inclusive. Two hundred and five women were delivered by caesarean giving a caesarean section rate of 8.3%. One hundred and ninety-eight (96.6%) case records were retrieved for analysis. Eighty-eight patients (44.4%) had one or more intra- and/or postoperative complications. Sepsis was the commonest complication involving 62 (70.4%) women. All were cases of emergency caesarean section. The incidence of other complications were anaemia, 59 (67%); hemorrhage, 38 (43.2%); and wound dehiscence, 11 (12.5%). There were two maternal deaths (2.3%) due to an anaesthetic accident and septicaemia respectively. The factors resulting in complications of the caesarean deliveries were prolonged obstructed labour, prolonged rupture of fetal membranes, previous caesarean sections, antepartum haemorrhage and severe pre-eclampsia and eclampsia. A review of the use of prophylactic antibiotics in selected cases, early recourse to operation in cases with cephalo-pelvic disproportion, and the acquisition of trained anaesthetists are advocated.