Caesarean delivery in urban second tier missionary hospital in Nigeria

Objective: To determine the current trend of Caesarean and highlight the role of a major operative obstetric practice in materno-foetal medicine.Design: Descriptive case study.Setting: St Philomena Catholic Hospital (SPCH), an urban second tier missionary hospital.Subjects: One thousand and fourteen (1014) Caesarean deliveries that took place at the centre between January 2009 and December 2013. Main outcome measures: These were Caesarean section rates, the trend, indications and materno-foetal complications.Results: The rate of Caesarean birth in this study was 1014(21.0%), EMCS constituted 816(80.5%) and elective CS 198(19.5%).The leading indications for EMCS were cephalopelvic disproportion(CPD)323 (39.6%) and obstructed labor 135(16.5) while previous caesarean section 102(51.5%) and breech presentation 41(20.6%) were the leading indications for elective CS. The major maternal complications were postpartum haemorrhage 7.2% and post-partum anaemia 47.7% for EMCS and the values for ELCS were 6.6% and 36.9% respectively. The perinatal complications were Apgar score <7 at 5 minute 5.1% vs. 1.5% Odd ratio (OR) 3.5, P-value (P) 0.021 and SCBU admission 7.1% vs. 2.6% OR 2.9, P 0.014 respectively for EMCS and ELCS. The composite perinatal complications were 15.2% vs. 7.6%, OR 2.2, P 0.0039.Conclusion: To the obstetric world, we proffer quality prenatal care, quality labuor supervision and strict case selection based on medical and obstetric merits for Caesarean births

Perception of prenatal services by antenatal clinic attendees in a tertiary health facility in Nigeria

Background: Antenatal patronage is very low in most sub-Saharan African countries, Nigeria inclusive. It has also been recognised that most women who registered for antenatal care in a particular health institution, do not go back to the same centre to deliver when in labour. Skilled attendant delivery is very low in Nigeria. While many reasons can be adduced for this health seeking behaviour, antenatal care satisfaction is one of them. We decided to study how satisfied are the antenatal subjects at the Federal Medical Centre, Yenagoa.Objective: The objective of this study is to determine antenatal mothers’ perception of prenatal services at the Federal Medical Centre, Yenagoa, Nigeria.Materials and Methods: This was a descriptive cross-sectional observational study conducted at the Federal Medical Centre, Yenagoa, Nigeria between 1st of June 2015 and 30th of September, 2015. A pretested questionnaire was administered to 198 consecutive antenatal attendees at the centre by two Interns serving in the department of Obstetrics and Gynaecology.Results: The mean number of antenatal visits was 4.2 ± 2.52 and the median was 4.0. One hundred and eightyseven (94.5%) said the antenatal health talks were very educative, 103(52%) think the antenatal care visits should be made more frequent, 43 (21.7%) think they should reduce the frequency of visits, 183(92.4%) rated services at the centre from being good to excellent. One hundred and twenty-five (56.6%) respondents were generally dissatisfied with long waiting time to see doctors.Conclusion: The majority of mothers were happy with services and interventions rendered at the institution, measures that have been known to improve women’s health in pregnancy and also improve perinatal outcomes. However, a sizeable proportion of subjects were unhappy with long waiting time to see a doctor, an issue that had dogged obstetric practice in sub-Saharan Africa. This issue needs to be tackled by caregivers and stakeholders alike.Keywords: Antenatal care services, Patients satisfaction, Antenatal visits, Perinatal mortalit