Outcome of emergency caesarean sections in Calabar, Nigeria: Impact of the seniority of the medical team.

We set out to assess the maternal outcome of emergency caesarean sections in University of Calabar Teaching Hospital (UCTH) in relationship to the seniority and experience of medical personnel involved in the operation. This was a review of 349 cases of emergency caesarean sections in UCTH over a 2-year period (January 2000-December 2001). The sociodemographic data, antenatal booking status and clinical condition of the patients as well as the seniority of the medical staff who participated in the operations were extracted from the case notes of the patients. A total of 280 (80.0%) booked patients and 69 (20.0%) unbooked mothers were delivered by emergency caesarean sections. The consultants performed only 16.4% of the emergency caesarean sections, while the residents performed 83.6%. Similarly consultant anaesthetists administered anaesthesia in 12.9% of the cases. A total of 12 maternal deaths occurred from emergency caesarean sections in which six (1.7%) were due to sepsis, three (0.8%) due to severe haemorrhage and three (0.8%) due to anaesthetic complications. None of the deaths occurred in operations in which consultant obstetricians and anaesthetists were involved. The intraoperative blood loss was more in operations performed by the residents than in those performed by the consultants. Similarly, morbidity was higher in patients operated upon by residents. The maternal morbidity and mortality associated with emergency caesarean sections in UCTH would be reduced significantly if consultant obstetricians and anaesthetists were more involved in these operative procedures.