A review of caesarean delivery in Southwest Ethiopia: incidence, indications and outcomes

Background/Aims: Although the rate of caesarean delivery has increased dramatically worldwide, data reported from 1991 to 2003 show that most low-income countries have a caesarean delivery rate of less than 10%, while more than 30% of middle- and high-income countries exceeded 20%. The most recently available data from the World Health Organization (WHO) indicate that more than half of high-income countries have a caesarean delivery rate in excess of 25%, with caesarean sections accounting for approximately 32.3% of births in the US. The four most common indications for caesarean deliveries are: i) failure to progress during labour; ii) previous hysterectomy; iii) non-reassuring fetal status; and iv) fetal malpresentation. In this article, the authors aimed to investigate the incidence, indications and outcomes of caesarean sections in Southwest Ethiopia. Methods: A hospital-based cross-sectional survey was conducted and data were collected and analysed for statistical significance. Results: Based on the data collected, the region's caesarean delivery rate was found to be 27.6%. The average age of patients in the study was 26.9±5.04 years (15–40 years). The leading indications for caesarean section are: cephalopelvic disproportion (32.3%); previous caesarean section (24.2%); fetal distress (18.1%); malpresentation and malposition (8.8%); and antepartum haemorrhage (4.2%). There were no maternal deaths recorded, but the overall maternal morbidity rate was 15.4%. Conclusions: The caesarean delivery rate in Southwest Ethiopia is markedly higher than the recommended rate set by WHO for developing countries (15%). However, the maternal morbidity rate is still high and further research needs to be carried out on the causes and prevention of such cases.