Prevalence of primary Caesarean Section deliveries among primiparous and multiparous women at Iringa Regional Referral Hospital, Tanzania

摘要

Introduction: Primary Caesarean Section (CS) is an operation that is performed for the first time on a pregnant woman. Primary CS is of particular interest because it has an influence on future modes of delivery. There is also an issue about the original indication for the procedure both in a woman who has never tried her pelvis for vaginal delivery and a woman who has delivered vaginally in the past. Objectives: To determine the prevalence, indications, and outcomes of primary CS deliveries among primiparous and multiparous women, and associations with some demographic characteristics among pregnant women who deliver at Iringa Regional Referral Hospital, Tanzania. Methods: An analytical cross section hospital based study was used with a quantitative research approach. A sample size of 247 of primary CS deliveries was obtained. A structured questionnaire was used to collect the data and the Statistical Package for Service Solutions (v. 23) software programme was used for data entry and analysis. Results: The prevalence rate of primary CS delivery was 247 (21.6%) out of 1144 deliveries between January 2017 and June 2018. The highest indication for CS was foetal distress which was foetal heart rate below 120b/m and above 160 b/m 79 (32.0%) followed by prolonged labour 65 (25.1%). Maternal outcomes revealed that 65 (26.3%) women experienced significant blood loss which was above 1000mls, with blood transfusion of at least more than one unit of blood (PPH) followed by 29 (11.7%) who experienced a high body temperature above 37.5 degree of centigrade. The new born outcomes found that 128 (51.8%) were unable to breast feed and 95 (38.5%) had low Apgar scores below 7 in the 1st and 5th minute. Conclusion: There was a high prevalence of primary CS among primiparous and multiparous women which is above the recommended WHO threshold of 15%. Also, the highest indication for primary CS was foetal distress. The most common complication for the mother was significant blood loss and the commonest newborn complication was that the baby was unable to breastfeed.