TITLE:
Indications and Immediate Outcomes of Caesarean Section at Primary Health Care Facilities in Rural Tanzania
AUTHORS:
John Somi, Amani Idris Kikula, Saidi Ali, Fadhlun M. Alwy Al-Beity, Rafiki Nickson Mjema, Paul Emmanuel Ndeki, Peter P. Kunambi, Charles Kilewo
KEYWORDS:
Primary Health Facility, Caesarean, Indications, Immediate Outcomes
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.14 No.12,
December
23,
2024
ABSTRACT: Objective: To determine the indications and immediate maternal and fetal outcomes of caesarean section performed at primary health facilities in 2020. Design: Discriptive cross-sectional study. Setting: Lushoto District Council is located in the northeastern in Tanga region, Tanzania. Participants: All women who underwent caesarean section at primary health facilities from January to December 2020, 782 included in this study and 72 files were missing. Main outcome Measures: Indications and immediate maternal and fetal outcomes of caesarean section at primary health facilities. The difference in indications and outcomes of caesarean section between district hospital and upgraded health centres. Results: The commonest indications were obstructed labor 29.0%, previous scar(s) 19.9% and fetal distress 17.0%. Obstructed labour indication was more at the upgraded health centres. Most, 89% of women had no post-operative complications. The common maternal complications were hemorrhage 5.7%, transfusion 5.2%, prolonged stay 1.7%. Most babies were alive 95%, term 90% with Apgar score > 7 at 5 minutes 96% and 94% had birth weight ≥ 2500 g. There were no statistically significant differences in immediate maternal and fetal outcomes between health centres and district hospital. Conclusions: Obstructed labour was the commonest indication for caesarean section. The immediate maternal and fetal outcomes at the upgraded health centers were comparable to the district hospital level. Clinical audits of indications for caesarean section and prospective studies for late maternal and fetal outcomes of caesarean section performed at primary health facilities to be conducted.