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100			_aPhillip, Raphael _d CUHAS/MD/4000384/T/09 _920057
245			_aIndications, Maternal and Fetal Outcome of Caesarian Section at Bugando Medical Centre, Mwanza
260			_aMwanza, Tanzania: _bCatholic University of Health and Allied Sciences [CUHAS – Bugando]: _b Phone: +255 28 298 3384 : _b Fax: +255 28 298 3386 : _b Email: vc@bugando.ac.tz : _b Website: www.bugando.ac.tz : _c © 2014
300			_a viii; 44 Pages
300			_aIncludes Refferences and Appendices
520			_aAbstract: Background: Cesarean section (CS) is a surgical procedure used to deliver one or more babies, usually performed when vaginal delivery will put the mother or child’s health or life at risk. In recent years, the number of CS has risen worldwide. Since CS also involves risk for adverse outcome for both mother and child, concern has been expressed regarding its increased use. The main aim of this study was to investigate indications, maternal and fetal outcome of caesarean section at Bugando Medical Centre, Mwanza, Tanzania. Methods: A retrospective hospital based study was done by reviewing 310 case notes of patients who underwent CS in the period of January to December 2013. Data were collected using the data collection sheets/checklists from MTUHA books and Medical files at BMC labour ward and medical record. Data entry and analysis was done using Microsoft excel and SPSS version 17.0 respectively. Results: A total of 310 case notes of Caesarean section from January 2013 to December 2013 were reviewed among a total 9,100 cases admitted for delivery, and 2,009 caesarean sections which were performed, thus giving a frequency of 22.08% for CS. Most common indications were 85 (27.4%) for previous scar, 78 (25.1%) for prolonged or obstructed labour, 56 (18.1%) for fetal distress, 25(8.1%) for fetal malpresentations, 16 (5.2%) for preeclampsia, 11 (3.5%) for multiple pregnancy, 9 (2.9%) CS was done following maternal requests, 8 (2.6%) for eclampsia, 5(1.6%) for antepartum haemorrhage, 5 (1.6%) for PROM, while no CS was done for the indication of PMTC. There were only 2 (0.6%) patients who got maternal complications followings CS. It was post-partum haemorrhage. Total of 69 (22.3%) newborns born by CS developed complications. 34 (11%) had low Apgar score, 10 (3.3%) were pre mature, 13 (4.2%) had birth asphyxia, 16 (5.2%) had meconium aspiration, 4 (1.3%) had umbilical sepsis, 1 (0.3%) had trauma to the legs, while 5 (1.6%) died. Conclusion: Caesarean section rate at BMC is 22.08%. This exceeds the internationally recommended rate of 15%. Emergency CS being more common (65%) than elective procedures (32.9%). Rate of CS observed at BMC is similar to other tertiary hospital and higher than the national CS rate. It reflects lack of facilities and competent manpower in District hospitals and Regional hospitals as a result many emergence obstetric cares which could be managed in these hospitals are also referred to tertiary hospitals. There are few maternal complications of CS at BMC, influenced by presence of competent gynecology and obstetrics team at BMC. However, total of 69 (22.3%) newborns born by CS developed complications, the commonest complication 34 (11%) being low Apgar score, followed by meconium aspiration 16 (5.2%) and birth asphyxia 13 (4.2%). These complications show that action to prolonged labour is done late probably due to delay in decision to refer patients or delay during transport process to referral hospital.
600			_xObstetrics and Gynecology _948284
700			_a Matovelo, Dismas _920052
942			_2ddc _cCR
999			_c20266 _d20266