A Review of Caesarean Delivery at the Kogi State Specialist Hospital, Lokoja, Nigeria

Background: Caesarean delivery rate is increasing globally including in Nigeria. Caesarean delivery is a life-saving surgery for both mother and child. Objective: The aim of the study was to assess the caesarean delivery rate at the Kogi State Specialist Hospital, Lokoja, Nigeria over a one-year period. Methods: This was a prospective assessment of the demographic characteristics of patients, indications, types, rates and outcomes of Caesarean delivery in Kogi State Specialist Hospital, Lokoja, Nigeria from December 15, 2020 to December 14, 2021. Data collected were analyzed using SPSS version 20.0 statistical package (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp). The categorical data were displayed using tables and charts. Results: There was a total of 491 deliveries, out of which were 113 Caesarean deliveries and 378 spontaneous vaginal deliveries making the Caesarean delivery rate in Kogi State Specialist Hospital, Lokoja, Nigeria 23.0%. There were no instrumental deliveries during the study period. The commonest indication for Caesarean section was obstructed labour in 31% of cases. There was no maternal mortality. There were three early neonatal deaths due to severe birth asphyxia. Conclusion: The rate of Caesarean delivery in this study was 23.0% and obstructed labour was the leading indication in 31% of cases. The rate of Caesarean delivery in this study is high, albeit the overall outcome was good for both mother and child. Caesarean delivery, therefore, remains one of the means for reducing maternal and perinatal morbidity and mortality in Nigeria.

A woman by successful IVF and caesarean delivery without complications in autosomal dominant centronuclear myopathy

Autosomal-dominant centronuclear myopathy is a rare hereditary disease in adolescents,mainly involving the distal muscles of the lower extremity.It is extremely rare in pregnancy.This study presented a case of a woman by successful IVF and caesarean delivery without complications in autosomal dominant centronuclear myopathy.This report also reviewed the clinical spectrum of CNM and its management,which resulted in the delivery of a healthy infant.It is important that the clinician has a clear understanding of the clinical spectrum of CNM,the available methods for perinatal diagnosis,and optimal antenatal care.A multidisciplinary team approach is emphasized,with specific reference to the method of analgesia and anesthesia during labor and route of delivery.

Effect of the new maternity insurance scheme on medical expenditures for caesarean delivery in Wuxi, China： a retrospective pre/post-reform case study

Aiming to control rising medical expenditures and help improve China＇s healthcare systems, this study examined whether a cap-based medical insurance scheme with shared financial interest between the insurance and healthcare providers is effective in containing hospitals＇ C-section medical expenditures. We used 6547 caesarean delivery case records from a teaching tertiary-level general public hospital located in Wuxi, China （2004-2013）, and used the Chow test to investigate the possibility of significant variation in mean medical expenditures for caesarean deliveries pre- and post-reform. We also used paired sample t-tests and linear regression models to compare the mean medical expenditures between insured and uninsured women undergoing caesarean delivery during the post-reform period. After the scheme＇s implementation, medical expenditures for caesarean deliveries declined and the medical expenditures of women covered by the scheme were significantly lower than those of uninsured patients. These findings indicated the scheme＇s effectiveness in minimizing caesarean delivery expenditures. The cap-based medical insurance scheme with shared financial interest between insurance and healthcare providers would likely steer healtbcare providers＇ behaviors in a more cost-effective direction.