Analysis of caesarean delivery in Jimma Hospital, south-western Ethiopia.

In this prospective study, 100 mothers who have undergone caesarean section in Jimma Hospital from 23rd June 1992 to 24th September 1993 were analysed to determine the incidence, indications and post operative complications of caesarean delivery. During the study period, there were 1236 deliveries, of whom 100 mothers were delivered by caesarean section; giving a caesarean birth rate of 8%. The leading indications for caesarean section were cephalopelvic disproportion (44%), malpresentations and malpositions (21%), repeat caesarean section (16%), antepartum haemorrhage (8%) and foetal distress (6%), accounting for 95% of the indications for caesarean section. There was no maternal death, but the overall morbidity rate was 20%. The causes of morbidity were wound infection (27.1%), sepsis (21.4%), endometritis (33.3%), haemorrhage (8%) and wound dehiscence (10%). The gross perinatal mortality rate of 120 per 1000 live births was not significantly higher than the rate for all deliveries, which was 92.5% per 1000 live births (P < 0.5). The single most important cause of perinatal death was prolonged and obstructed labour. In order to reduce the high perinatal mortality and maternal morbidity, there is a strong and urgent need to prevent prolonged and obstructed labour through effective antenatal care and referral system.