Research - Obstetrics and Gynaecology

Indications  and Outcomes of emergency caesrean sections at Mbarara Referral Hospital Uganda. Atwine F, Kumakech E, Batwala V,Mwizerwa J, Waswa-Ssalongo G

Abstract

Emergency caesarean section is a common invasive surgical intervention in obstetric practice. A study was conducted to describe the indications and outcomes of emergency caesarean section among mothers attending Mbarara Referral Regional Hospital in south west Uganda.A retrospective analysis of all documented non elective caesarean sections during a 36 months period from 2000-2002 in the delivery ward was performed. The principal indications were: obstructed labour (30.6%,) malposition/ malpresentation (23.6%), previous caesarean section (13.7%) cephalopelvic disproportion (9.2%) and repaired vesico –vaginal fistula (0.9%). The adverse outcomes were wound infections/sepsis, anaemia intestinal obstruction and prenatal mortality.  In conclusion, some of the principal indications are easily identified before labour and their associated complications are preventable. There is need to increase community awareness regarding life threatening obstetric complications as well as the need for skilled attendance to delivery. Further, still there is need to develop an effective referral system to strengthen skilled detection of high risk pregnancies by primary health care workers and traditional birth attendants , the use of the labour monitoring tool and to strengthen the emergency preparedness.

Key words: Emergency caesarean section, indications, outcomes, Uganda.