Abstract:
Background: Caesarean section (CS) is the most common surgical procedure performed in
obstetrics practice, with the sole aim of reducing feto-maternal morbidity and mortality.
Worldwide and institutional based studies have shown increasing trend in CS. The aim of
the study was to determine the annual trends in caesarean section rates, indications, fetal
and maternal outcomes at Mandera County Referral Hospital (MCRH), Mandera County,
Kenya.
Methodology: A hospital based descriptive cross-sectional study of women (n=783) who
underwent caesarean section at Mandera County Referral Hospital, Mandera County,
Kenya from 1st January 2013 to 31
st December 2017, was performed. Data on socio demographic and obstetric characteristics, indications for CS, fetal and maternal outcomes
were extracted from the women’s medical records using a structured checklist by two
trained research assistants. Analysis was done using the Statistical Package for Social
Sciences (SPSS) version 23.0. Categorical variables were summarized using frequency and
proportions, the linear trend over time was determined by chi-square using the statistical
software EpiInfo, with a p-value of less than 0.05, considered to be statistically significant.
Results: During the period under review (2013-2017), a total of 7,613 deliveries were
recorded, amongst them, 783 were caesarean sections (10.3%). Emergency caesarean
section was more prevalent than elective caesarean section (96.3% vs 3.7%). The most
common indication for CS was previous caesarean section at (23.7%). The most frequent
adverse fetal and maternal outcomes were new born unit admission (13.2%) and blood
transfusion (35.9%), the overall case fatality rate was (2.1%).Trend analysis for blood
transfusion over the 5 years was significantly decreasing with a p-value of 0.007*.
Conclusion: The average caesarean section rate at Mandera County Referral Hospital,
Mandera County, Kenya, over the study period under review stands at 10.3%. The key
findings of the study were the high frequency of adverse feto-maternal outcomes among
participants who underwent caesarean sections.
