Background: Caesarean delivery is an operation done to deliver a baby through an incision in the uterus. It is the most frequently performed surgical procedure worldwide, rates of the caesarean delivery across countries ranges from 10% to 40%. The causes can be due to cephalopelvic disproportion, uterine inertia, placenta previa, malposition and malpresentation, fetal distress and other more. Previous caesarean section has been found to be the commonest cause of increased caesarean section in many parts of the world. This research was done in order to assess fetal outcome and mode of delivery in women with one previous caesarean section at Bugando Medical Centre, Mwanza-Tanzania.
Methodology: The retrospective study conducted in Medical Records Department at Bugando Medical Centre, Nyamagana district, Mwanza-Tanzania from October 2021 to December 2021. The study was hospital based involving files of female patients who had history of one previous caesarean section, data were filled in questionnaire forms and entered and analyzed using SPSS software version 20.
Results: A total of 150 files of women with previous one caesarean section delivery, were included in the study. Age of the patients ranged from 19 to 43 years with a mean age of 29.67 years with mode of 33 years.42 women (28.0%) had ERCS ,13women (8.7%) had successful VBAC and 95women (63.3%) had emergency Caesarean section this was due to failure TOS and other obstetric indications apart from failed VBAC. the fetal outcome of the women was as, majority of newborns weighted 2.5 to 4.0 kg 111(74.0%),32(21.3%) weighted less than 2.4kg and 7(4.7%) of neonates had weight of more than 4kg.Among the neonates death was 7(4.7%) which included stillbirth and those died shortly after birth and 143(95.3%) were alive, with fifth minute Apgar score 9(6.0%) had score of < 7 ,137(91.3%) had score of greater or equal to 7 and 4(2.7%) had score of 0.Out of the 150 newborn both dead and alive 54(36.0%) required ICU admission due to various reasons and 96(64.0%) had no ICU admission.
Conclusion: From the study majority of women with one previous Cesarean section undergo emergence C/S .Fetal outcome in all mode of delivery in women with one previous C/S is general good.
= OPERATIONAL DEFINITIONS Caesarean section means delivery of the foetus, membrane and placenta after 28weeks of the gestation by opening of the abdomen and uterus. OPERATIONAL DEFINITIONS Elective Repeated caesarean section – operation that done at a pre-selected time before onset of labour, usually at completed 39 weeks. OPERATIONAL DEFINITIONS TOL – trial of labor after caesarean section to achieve VBAC. OPERATIONAL DEFINITIONS Cephalo-pelvic Disproportion(CPD)- is failure of the foetus to pass safety through the birth canal because the fetal head being relatively larger than maternal pelvic size.
= LIST OF ABREVIATION BC Before Christ BMC Bugando Medical Centre CDC Centre for Disease Control C/S Caesarean section CUHAS Catholic University of Health and Allied Science ERCS Elective repeated caesarean section NICU Neonatal intensive care unit TOS Trail of scar VBAC Vaginal birth after caesarean section WHO World Health Organization