Emergency caesarean section and its sequelae in a tertiary hospital in Niger Delta, Nigeria


  • Rose Sitonma Iwo-Amah Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
  • Felix Chikaike Clement Wekere Department of Obstetrics and Gynaecology, Department of Community Medicine, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
  • Simeon Chijioke Amadi Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
  • Joseph Ngozi Kwosah Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria




Caesarean section, Complications, Emergency, Prevalence, RSUTH


Background: Caesarean section (CS) is one of the most common surgical procedure in obstetrics. It involves a surgical incision made through the abdominal and uterine walls to deliver the foetus and placenta after the period of foetal viability.

Methods: This was a cross-sectional study aimed at reviewing emergency caesarean section in Rivers State University Teaching Hospital (RSUTH) over a 5-year period, to determine the prevalence and sequelae. Data were analysed using IBM Statistical Product and Service Solution (SPSS) version 25.0 (Armonk, NY).

Results: During the review period, there were 13516 deliveries and 3699 cases of emergency CS, giving the prevalence of emergency CS as 27.4% or 274 per 1000 deliveries. Majority (90%) of the parturient were unbooked. The most common complication in women that had emergency caesarean section was fever (56.4%), followed by endometritis (14.7%), absconding from hospital (8.8%), urinary tract infection (7.1%) and wound infection (6.1%). There was a statistically significant association between types of CS and their sequelae, χ2=1153.9, p<0.001, (95% CI: 0.000, 0.000). Women that had emergency CS were 101 times more likely to have a complication compared to those that had planned CS.

Conclusions: The rate of emergency caesarean section is high in RSUTH and with more complications compared to planned caesarean section. Booking for antenatal care, early presentation for delivery, birth preparedness and complication readiness will enhance improved maternal and perinatal outcome.



Danforth DN. Danforth’s obstetrics and gynecology. 10th edn. Lippincott Williams and Wilkins; 2008.

Gelaw KA, Aweke AM, Astawesegn FH, Demissie BW, Zeleke LB. Surgical site infection and its associated factors following cesarean section: a cross sectional study from a public hospital in Ethiopia. Patient Safety Surg. 2017;11(1):1-7.

Kwawukume E, Laryen H. Caesarean section. In: Kwawukume EY, Ekele BA, Danso KA, Emuveyan E, eds. Comprehensive obstetrics in the Tropics. 2nd edn. Accra: Asante and Hittscher Printing Press Ltd; 2015:205- 414.

Tsegaye H, Desalegne B, Wassihun B, Bante A. Prevalence and associated factors of caesarean section in Addis Ababa hospitals, Ethiopia. Pan Afr Med J. 2019;34.

Leung TY, Lao TT. Timing of caesarean section according to urgency. Best Pract Res Clin Obstet Gynaecol. 2013;27(2):251-67.

Idikwu OG, Onazi O, Anzaku AS, V F. Emergency caesarean deliveries: Analysis of 592 cases in federal medical centre Keffi, North Central Nigeria. Int J Clin Obstet Gynaecol. 2018;2(5):100-3.

Lucas DN, Yentis SM, Kinsella SM, Holdcroft A, May AE, Wee M, et al Urgency of caesarean section: a new classification. J Royal Soc Med. 2000;93(7):346-50.

Jaiyesimi RA, Ojo OE, Awe AF. Caesarean delivery and peripartum hysterectomy. Contemp Obstet Gynecol Develop Countries. 2021:203-21.

Gunn JK, Ehiri JE, Jacobs ET, Ernst KC, Pettygrove S, Center KE, et al. Prevalence of Caesarean sections in Enugu, southeast Nigeria: Analysis of data from the Healthy Beginning Initiative. PloS One. 2017;12(3):e0174369.

Ezeonu PO, Ekwedigwe KC, Isikhuemen ME, Eliboh MO, Onoh RC, Lawani LO, et al. Perception of caesarean section among pregnant women in a rural missionary hospital. Adv Reprod Sci. 2017;5(3):33-8.

Ajayi AI. Inequalities in access to birth by caesarean section in the context of user fee exemption for maternal health services in southwest and north central Nigeria. Int Health. 2020.

Wekere FCC, Kua PL, Kalio DG, Iwo-Amah RS. Assessing the awareness, ownership and utilization of insecticide-treated bed nets amongst antenatal clinic attendees: a tertiary hospital-based study. Asian Res J Gynaecol Obstet. 2020:21-9.

National Population Commision (NPC). Rivers State, Nigeria Population statistics. 2006. Available from: https://www.citypopulation.de/php/nigeria-admin.php?adm1id=NGA033. Accessed on 8 September 2021.

Osonwa O, Eko J, Ekeng P. Trends in caesarean section at Calabar general Hospital, Cross river state, Nigeria. Eur J Biol Med Sci Res. 2016;4(1):1-5.

Nwobodo E, Isah A, Panti A. Elective caesarean section in a tertiary hospital in Sokoto, north western Nigeria. Niger Med J. 2011;52(4):263.

Gulati D, Hjelde GI. Indications for Cesarean Sections at Korle Bu Teaching Hospital, Ghana. 2012.

Prah J, Kudom A, Afrifa A, Abdulai M, Sirikyi I, Abu E. Caesarean section in a primary health facility in Ghana: clinical indications and feto-maternal outcomes. J Public Health Afr. 2017;8(2).

Akinola OI, Fabamwo AO, Tayo AO, Rabiu KA, Oshodi YA, Alokha ME. Caesarean section- an appraisal of some predictive factors in Lagos Nigeria. BMC Pregnancy Childbirth. 2014;14(1):1-6.

Osegi N, Makinde OI. Towards optimizing caesarean section: a five-year review of caesarean sections at a Southern Nigeria hospital. Int J Reprod Contracept Obstet Gynecol. 2020;9(1):205-11.

Daniel C, Singh S. Caesarean delivery: an experience from a tertiary institution in north western Nigeria. Niger J Clin Pract. 2016;19(1):18-24.

Chukwu E, Ekeh C, Haruna H, Chia T, Fiase T. Prevalence of caesarean section deliveries among primigravidae in general hospital Gboko, Benue State, Nigeria. Int J Clin Pediatr Surg. 2017;3(3):25-9.






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