Primary caeserean section in grandmultiparae at Mater Misericordiae Hosptial Afikpo: a 5 year retrospective study

To identify the common indications and the outcome of primary caesarian section in grandmultiparae at Mater Misericordiae Hospital Afikpo. The case notes of 69 grandmultiparae who had primary caesarean section at Mater Misericordiae Hospital Afikpo between January 1999 to December 2003 inclusively. The information obtained included age, parity, occupation, height, educational status, booking status, indication for caesarean section, operative and post-operative complications, types of anaesthesia, types of uterine incision, mean blood loss, associated pelvic findings and foetal outcome. Eighty nine percent (89%) of 69 primary caesarean sections were done emergency procedure. The commonest indications for a caesarean section were dystocia (76.8%), antepartum haemorrhage (17.4%), essential hypertension (10.1%) Puerperal pyrexia (24.6%), haemorrhage (7.2%) wound dehiscence (4.3%) and anaemia (2.9%), were the commonest intra- and post operative complications encountered. The perinatal mortality rate was 153/1000. There were two maternal deaths (29 per 1000). Health education of the population coupled with better utilization of comprehensive maternity care and family planning facilities are advocated.