Join point trends of instrumental vaginal deliveries and cesarean sections at the Lagos University Teaching Hospital, Lagos, Nigeria (2002-2017).

Autor: Olamijulo JA; Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, LUTH, Lagos, Nigeria.; College of Medicine, University of Lagos, Lagos, Nigeria., Aliyu Z; Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, LUTH, Lagos, Nigeria., Olorunfemi G; Division of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Johannesburg, South Africa., Adeyinka AT; Eli Lilly Hospital, Benin, Nigeria., Ubom AE; Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria., Abikoye O; Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, LUTH, Lagos, Nigeria.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Oct; Vol. 167 (1), pp. 445-452. Date of Electronic Publication: 2024 Jun 12.
DOI: 10.1002/ijgo.15707
Abstrakt: Objective: To determine the trends of instrumental vaginal delivery (IVD) and cesarean section (CS) at the Lagos University Teaching Hospital (LUTH), Nigeria, over 16 years, from 2002 to 2017.
Methods: A retrospective cross-sectional study. The case records of all women who had IVD and CS during the study period were reviewed. The trends in the IVD and CS rates were evaluated using join point regression modeling. The average annual percent change (AAPC) and annual percent change (APC) with associated 95% confidence interval of segmental trends were calculated.
Results: The overall IVD rate was 1.36%. Vacuum delivery rate was higher than forceps (0.79% vs 0.57%). The CS rate was 44.9 per 100 deliveries; the rate increased by about 3.7% per annum. CS rates were 7.1-89.9 times the IVD rates within the study period. The number of IVDs performed in the hospital declined by about 83.02%, from 53 cases in 2002 to nine cases in 2017. Forceps delivery declined at a faster rate than vacuum delivery between 2002 and 2017 (AAPC for forceps: -12.6% [-17.5 to -7.5], P < 0.001 vs AAPC for vacuum: -6.2% [-14.3 to 2.7], P = 0.200). The commonest indication for IVD was prolonged second stage of labor (47/162, 29.01%) and shortening of the second stage of labor for maternal conditions (47/162, 29.01%).
Conclusion: IVD rates are low and declining at LUTH. There is need to train accoucheurs on the safe use of IVDs to potentially reduce the CS rate.
(© 2024 International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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