Pattern of primary caesarean deliveries in a Nigerian tertiary hospital

Abimbola T. Ottun, Chinonye H. Okoye, Adeniyi A. Adewunmi, Faosat O. Jinadu, Ayokunle M. Olumodeji


Background: Primary caesarean section (CS) has become a major driver of the steadily rising total caesarean rate. This study determined the primary CS rate, pattern and associated factors.

Methods: It was a retrospective, hospital-based cross-sectional study of 645 pregnant women who had primary caesarean section over a 3-year period in Lagos state university teaching hospital, Lagos, Nigeria. Data obtained were expressed in frequency and percentages.

Results: Primary CS accounted for more than 50% of all the CS done during the study period with a primary CS rate of 16.7% and total CS rate was 30.6%. Primary CS was commonest among women of age group 30-39years (50.1%) and women with no prior parous experience (58.6%). The commonest indication for primary CS was poor progress in labour due to cephalopelvic disproportion, which occurred in 170 women (26.4%), followed by suspected foetal distress in 94 women (14.6%) and hypertensive disease in pregnancy in 91 women (14.1%). Post-operative wound infection and/or dehiscence was the most prevalent post-operative complication occurring in 12.1% of women who had primary CS.

Conclusions: Primary CS rate is increasing and relatively more common among primiparous women. Cephalopelvic disproportion, suspected foetal distress and hypertensive disorders of pregnancy are the leading indications for primary CS.



Primary caesarean section, Caesarean section, Caesarean delivery

Full Text:



WHO. WHO Statement on Caesarean Section Rates. Geneva: World Health Organization. Geneva 2015. Available at handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1. Accessed on 17 March 2021.

De Souza HCC, Perdoná GSC, Marcolin AC, Oyeneyin LO, Oladapo OT, Mugerwa K et al. Development of caesarean section prediction models: secondary analysis of a prospective cohort study in two sub-Saharan African countries. Reproductive Health. 2019;16(1):165.

Geidam AD, Audu BM, Kawuwa BM, Obed JY. Rising trend and indications of caesarean section at the university of Maiduguri teaching hospital, Nigeria. Ann Afr Med. 2009;8(2):127-32.

Boerma T, Ronsmans C, Melesse DY, Barros AJ, Barros FC, Juan L et al. Global epidemiology of use of and disparities in caesarean sections. Lancet. 2018;392(10155):1341-8.

Betran AP, Torloni MR, Zhang JJ, Gülmezoglu AM; WHO Working Group on Caesarean Section. WHO Statement on Caesarean Section Rates. BJOG. 2016;123(5):667-70.

Gibbons L, Belizán JM, Lauer JA, Betrán AP, Merialdi M, Althabe F. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World health report. 2010;30:1-31.

Saha L, Chowdhury SB. Study on primary Caesarean section. Mymensingh Med J. 2011;20(2):292-7.

Betrán AP, Ye J, Moller A-B, Zhang J, Gülmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS One. 2016;11(2):e0148343.

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

World Health Organization. Monitoring Emergency Obstetris care. A handbook. Geneva Switzerland: World Health Organization; 2009;79-99. Available at: Accessed on 17 March 2021.

Osonwa OK, Eko JE, Ekeng PE. Trends in caesarean section at Calabar General Hospital, Cross River State, Nigeria. Eur J Biol Med Sci Res. 2016;4(1):1-5.

Isah AD, Adewole, Zaman. A five-year survey of Caesarean delivery at a Nigerian tertiary hospital. Trop J Obstet Gynaecol. 2018;35:14-7.

Batieha AM, Al-Daradkah SA, Khader YS, Basha A, Sabet F et al. Caesarean Section: Incidence, Causes, Associated Factors and Outcomes: A National Prospective Study from Jordan. Gynecol Obstet Case Rep. 2017;3(3):55.

John C, Alegbeleye J. Caesarean Delivery at a Teaching Hospital, South-South Nigeria: A Five-Year Review. Int J Trop Dis Heal. 2017;21(2):1-6.

Ugwu EO, Obioha KC, Okezie OA, Ugwu AO. A five-year survey of caesarean delivery at a Nigerian tertiary hospital. Ann Med Health Sci Res. 2011;1(1):77-83.

Panti A, Karima T, Nwobodo E, Yakubu A, Airede L, Egondu S. Caesarean morbidity and mortality in a tertiary health institution in Sokoto, North-West Nigeria. Orient Journal of Medicine. 1989;24:7-12.

Chama CM, El-Nafaty AU, Idrisa A. Caesarean morbidity and mortality at Maiduguri, Nigeria. J Obstet Gynaecol. 2000;20:45-8.

Okonta PI, Otoide VO, Okogbenin A. Caesarean section at the University of Benin Teaching Hospital revisited. Trop J Obstet Gynaecol. 2003;20:63-6.