Abstract:

Introduction: Cesarean section, also called a C-section, is a surgical procedure performed when a vaginal delivery is not possible or safe, or when the health of the mother or the baby is at risk. Primary caesarean section is an operation that is performed for the first time on a pregnant woman. Primary caesarean section is of a particular interest because it has influence on future modes of delivery. The prevalence of CS has been increasing worldwide and thus the rates have risen from 7% in 1990 to 21% today, and are projected to continue increasing over this current decade. One study shown CS rates among African countries ranged from 0.6% to 18%(2). The other study found CS rate in Tanzania ranging from 21.4% to 31.8%(3). The main aim of this study is to determine the rates and indications of primary CS so as to be able decreases long term risks and lowers the repeat caesarian delivery.

Objectives: This research was aimed at assessing prevalence and indications of primary caesarean section among pregnant women who delivered at Bugando Medical Centre from January 2023 to March 2023.

Methods: The study was hospital-based cross-sectional study which was conducted at Bugando Medical Centre at Nyamagana district in labor ward (C2) and post-natal wards (C4). The study population involved all pregnant women who delivered at BMC from January to March 2023. Data collected were analyzed using SPSS (Statistical package for social science) package version 23.

Study Population: The study involved all mothers who delivered through caesarian section and spontaneous vaginal delivery at BMC from January to March 2023

Results: The total number of deliveries at Bugando Medical Centre were 419, 366 and 423 in January, February and March respectively, the number of cesarean sections performed among those deliveries were 75, 45, 34 with the rate of primary cesarean section found to be 17.9%, 12.3% and 12.7% respectively. Most common indications of primary c-section were obstructed labor, prolonged labor, fetal distress, poor progression of labor, big baby, preeclampsia, premature rupture of membrane and arrested cervical dilatation which averagely accounted for 12%,10%,8%,6.9%,5.6%, 5.7%,4.2% and 7.3% respectively and least indications include fetal malpresentation cephalopelvic disproportion which accounted for less than 2% in three-month course. Majority of pregnant women underwent low segment cesarean section accounted for 84% of total cesarean section done.

Conclusion: Most obstetric indications of primary CS could be prevented by emphasize early booking of ANC visit with regular follow up to identify risk factors, hence reduce the rate of CS and improve morbidity and mortality rate of pregnant women and their babies. Also emphasize on LSCS should be done among obstetricians to ensure better outcome and for cosmetic purpose of pregnant women.