Background:

Caesarean section is one of the most performed surgeries across the whole globe. However, just like any major surgery, CS is associated with complications like haemorrhage, surgical site infection, Venous thromboembolism and anaesthesia related complications. These associated morbidity and mortality have been there despite improvements in blood transfusion services, the use of prophylactic antibiotics, anaesthesia and surgical techniques. This study aims to determine the rate of caesarean section complications, characterize their timing and identify risk factors to maternal complications among women delivered at KCMC hospital.

Method:

A cross-sectional analytical study of 386 women who delivered by CS at Kilimanjaro Christian Medical Center(KCMC) hospital from October 2018 to May 2019 was done. Data were obtained from the delivery register, patients, clinical and anaesthesia notes using a structured pre-tested questionnaire. Social-demographic characteristic, past medical, obstetric, surgical and family social history were sought from every study participant. Prevalence of complication was computed as a proportion of women with one or more complications out of all the women delivered during the study period. STATA version 13 was used for multivariable analysis to determine independent risk factors for the most prevalent complications. Odds ratio and 95% CI has been used to make an association. Whereby P-value <0.05 is considered statistically significant.

Results:

Out of 386 deliveries,106(27.5%) had one or more complications. The most common immediate complications were anaesthesia related, blood transfusion , postpartum hemorrhage(PPH), hysterectomy and ICU admission. While most common early complications (24 -72 hours of the operation) were puerperal sepsis, anaesthesia related complications, blood transfusion and ICU admission. Longer duration of surgery was significantly associated with all the complications (aOR 2.90, 95% CI 1.02-8.50), Grand multiparity was significantly associated with blood transfusion (aOR 7.0, 95% CI 1.40-34.35) and PPH (aOR 6.4, 95%CI 1.5-24.24) while pre-operative anaemia was significantly associated with blood transfusion (aOR 4.34,95% CI 1.90-9.45).

Conclusion:

Longer duration of surgery, grand multiparity and pre-operative anaemia are associated with complications. Hence, the medical team should be alert of the possible morbidity and mortality that can occur and get prepared beforehand.