Anesthesia for cesarean section in the University of Ilorin Teaching Hospital, Ilorin, Nigeria: A 5-year review

Background: Obstetric anesthesia service is peculiar in the practice of anesthesia because the anesthetist has to contend with the presence of two lives (the mother and the fetus) and the influence of changes in maternal physiology resulting from pregnancy. Cesarean section is the most frequently performed surgical procedure in obstetrics. With the increasing rates of cesarean deliveries in both developing and developed world, an audit of the outcome of anesthetic management is paramount to assess the safety of the procedure. Objective: The aim of this article is to audit obstetric anesthesia practice in the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria. Methods: The study was a total population study of all obstetric patients who had cesarean delivery at the UITH from January 1, 2010 to December 31, 2014. Results: A total of 14,155 deliveries were recorded from 2010 to 2014 out of which 3908 were cesarean sections giving a cesarean section rate of 27.6%. Ninety percent of the surgeries were emergencies. The most frequent indication for cesarean section was cephalopelvic disproportion (28.7%). Regional anesthesia was used in 92.1% whereas 7.9% had general anesthesia. The most frequent critical incident was hypotension (15.8%). Conclusion: Spinal anesthesia is the most frequently used form of anesthesia for cesarean section.