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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.