Epidemiology: Open Access

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Determinants of Caesarean Deliveries and its Major Indications in Adigrat Hospital, Northern Ethiopia: A Case Control Study

Samson Kahsay, Gebretsadik Berhe, Alem Gebremariam, Betel Birhane

Objectives: Ethiopia is among the few countries that have the highest maternal death. The aim of obstetricians is to achieve a healthy mother and healthy baby. To achieve this goal, caesarean section plays a vital role. But there was no adequate evidence on determinants and indications for caesarean delivers in Adigrat hospital. Therefore, the study was conducted to assess the determinant factors of caesarean deliveries and its indications in Adigrat hospital, Tigray region, North Ethiopia.

Design: Unmatched case control

Study Setting: Adigrat general hospital, Tigray, Ethiopia

Methods: A retrospective one year (July 2013 to June 2014) medical record review was conducted to select the cases and controls. The cases (152 caesarean deliveries) were all mothers delivered by caesarean section on the study period. Controls were vaginal deliveries in the same time period at Adigrat hospital selected by systematic random sampling. The case to control ratio was 1 to 2. Data was collected using data extraction form. Data was analysed using SPSS version 16. Multiple regression analysis was used to identify the independent effect of each variable on caesarean delivery.

Results: The institutional caesarean delivery rate was 14.23%. The commonest indication for caesarean section was cephalo-pelvic disproportion (29.6%) followed by non-reassuring foetal heart rate (21.1%) and failed vaginal delivery (12.5%). Independent risk factors found to be statistically associated with caesarean delivery were labour monitored without parthograph (AOR=15.6, 95%CI: 6.12, 40.0), un-booked ANC (AOR=3.5, 95%CI: 1.24, 10.33) and maternal age 35 years and above (AOR=3.2, 95%CI: 1.47, 6.85).

Conclusions: The caesarean delivery rate of the institution is comparable with the national institutional caesarean delivery rate of public hospitals. It is possible to decrease the caesarean delivery rate by increasing the ANC coverage and universal use of parthograph for all labours.