Abstract:
ABSTRACT
Background: Caesarean section (CS) rate is dramatically increasing in both developed and
developing countries across obstetric populations even those with minimal risk receive it. The
group of multiparous women with singleton pregnancy in cephalic presentation at term in
spontaneous labour, without history of previous CS has low risk for CS but yet high rate of CS
has been reported. The aim of this study is to audit for diagnosis of common indications for
CS against the criteria for standard diagnosis of indication for CS among women of low risk
group.
Methodology: A descriptive cross-sectional study was conducted at Muhimbili National
Hospital from 15th August to 31st December 2018. The common indication for CS among
women of low risk group were fetal distress, obstructed labour, arrested labour and
cephalopelvic disproportion. The criteria for standard diagnosis of these indications for CS
were adapted from International, National guidelines and peer groups publications based on
local expert consensus. The information was extracted from case notes and partographs
against the checklist for indications for CS and adapted criteria for standard diagnosis of
obstructed labour, fetal distress, arrested labour and cephalopelvic disproportion. The
proportions for indications for CS and standard diagnosis were analysed through composite
scoring using SPSS version 20.
Results: A total of 1670 emergency CS performed during the study period, 392 (23.5%) were
among the women of low risk obstetric characteristics for CS. Fetal distress 101(25.8%),
obstructed labour 92(23.5%), arrested labour 88(22.4%) and cephalopelvic disproportion
64(16.4%). Among the four indications for CS 55.1% meet the criteria for standard diagnosis
for indications for CS.
Conclusion: More than half of CS performed during the study period had meet the criteria for
the standard diagnosis of fetal distress, obstructed labour, arrested labour and CPD.
Recommendations: More studies to determine the factor hindering the adherence of the
criteria for standard practice among health care providers during clinical practice.
