PREDICTORS OF EMERGENCY SECOND CAESAREAN SECTION AMONG WOMEN WITH ONE PREVIOUS SCAR DELIVERING AT IRINGA REGIONAL REFERRAL HOSPITAL: HOSPITAL BASED CROSS-SECTIONAL STUDY: HOSPITAL BASED CROSS-SECTIONAL STUDY

Anicet Sebastian Mwaitala, Maria Angelica Rweyemamu, Athanase G. Lilungulu, Ipyana H. Mwampagatwa, Gabriel A. Kitinusa, Scholastica M. Malangalila, Alfred M. Laison, John D.T. Lawi, Francis R. Kwetukia, Enid Simon Chiwanga, Abeid Ikwasa, Wilfred Mwasamila

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: A significant increase in second emergency caesarean sections (CS) is associated with numerous adverse obstetric outcomes. Women have the opportunity to undergo planned childbirth, potentially preventing the need for a second emergency caesarean section. Objective: To determine the predictors of emergency second caesarean section among pregnant women delivering at Iringa Referral Hospital. METHODOLOGY: The study was conducted at Iringa Hospital over six months using a cross-sectional design. Participants were recruited serially, involving women with one previous scar arriving for delivery. Data were collected using a structured questionnaire, and analysis was conducted using SPSS. Chi-square tests were used to test the association of variables, and binary logistic regression assessed significance at a 95% confidence interval (CI) with a p-value <0.05. RESULTS: The study recruited a total of 355 participants who had second caesarean deliveries, with 204 (57.46%) having an emergency caesarean and 151 (42.54%) having an elective caesarean. The significant predictors of emergency second CS were lack of employment [AOR=3.02, 95% CI (1.59, 15.46)], late booking (11–20 weeks) [AOR=4.70, 95% CI (1.18, 18.64)] and >21 weeks [AOR=6.53, 95% CI (1.02, 41.67)], category of healthcare provider [AOR=3.87, 95% CI (1.30, 11.53)], lack of information on the mode of delivery during ANC [AOR=3.02, 95% CI (2.59, 15.46)], third-trimester ultrasound scanning [AOR=10.05, 95% CI (3.95, 25.61)], and pregnancy interval [AOR=10.05, 95% CI (3.95, 25.61)]. CONCLUSION: Emergency second caesarean sections (CS) are prevalent. Most women originate from primary healthcare centers, where nurses primarily manage them during ANC without establishing a birth plan. The number of antenatal visits and delays in booking exacerbate the situation. Therefore, all women with previous scars who arrive late for booking must receive attention from a physician. They should undergo critical evaluation and counseling on their birth plan.
Original languageEnglish
Pages (from-to)11-21
Number of pages11
JournalEthiopian Journal of Reproductive Health
Volume17
Issue number1
DOIs
Publication statusPublished - 1 Jan 2025
Externally publishedYes

Keywords

  • emergency
  • Iringa
  • Predictors
  • previous scar
  • second caesarean section

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