Dissertation (MMED Obstetrics and Gynaecology)
Background: Primary caesarian section is an operation that is performed for the first
time on a pregnant woman. Primary caesarean section is of particular interest
because it has an influence on future modes of delivery and is of concern as to what
was the indication for procedure in a woman who has never tried her pelvis for
vaginal delivery.
Objectives: The study intended to determine; prevalence, indications, management
outcomes of primary caesarean deliveries and association with some demographic
characteristics among pregnant women who deliver at Iringa Region Referral
Hospital, Southern Highlands of Tanzania.
Methods: It was an analytical cross section hospital based study with quantitative
research approach. A purposive sampling technique was employed for achieving a
sample size of 247 of primary caesarian deliveries. A structured questionnaire was
the main data collection method and the Statistical Package for Service Solution (v.
23) software program was used for data entry and analysis.
Results: Prevalence rate of primary caesarean delivery was 247 (21.59%) out of
1144 deliveries during the study period. Findings revealed that the highest indication
for caesarian section was fetal distress 79 (32.0%) followed by prolonged labor
65(25.1%). Maternal management outcomes revealed that 65 (26.3%) women
experienced blood loss followed by 29 (11.7%) who experienced high body
temperature. The new born management outcomes found that 128 (51.8%) were
unable to breast feed and 95(38.5%) had low Apgar score. A logistic regression
analysis revealed that women with primary and college/university education were
more likely to undergo primary caesarian section (P<0.05).
Conclusion: There was high prevalence of primary caesarean section among prime
and multiparous women which is beyond the recommended WHO threshold of 15%.
Also, highest indication for primary c/s was fetal distress; highest complication for
mother was significant blood loss and newborn management outcome was unable to
breastfeed.