| dc.description.abstract | Abstract
Classifying caesarean section rate using the Ten group classification system
– a descriptive study at Kilimanjaro Christian Medical Centre, Moshi,
Tanzania.
Degree Project, Programme in Medicine, Annika Malmborg, 2016,
Dept of Obstetrics and Gynaecology, Gothenburg University, Sweden and Dept. Of
Obstetrics at KCMC, Moshi, Tanzania
Background: Caesarean section (CS) can be life-saving for mother and child but the
operation can be followed by instant or longterm complications for both. CS rates are
increasing in both high income and low income countries. The WHO recommend no higher
CS rate than 15 % but at KCMC the rate exceeds 40 %. To keep the CS rate on an adequate
level, the Ten group classification system (TGCS), has been increasingly used to classify
women before delivery in ten groups and calculate the CS rate in each group in order to at
long sight improve the CS rate by adequate measures. The indications for CS differs a lot in
various settings, especially the percentage of maternal request for CS.
Aims: To classify the women giving birth at KCMC into the ten groups, to analyse the
CS rate in each group and also to describe the main indications for CS.
Methods: Retrieve information needed for classification from the delivery book and
case files for women giving birth at KCMC during the data collection period.
Results: The CS rate was 40.8%. The nulliparous women, and the women who have
had a previous CS contribute most to the overall CS rate. Nulliparous women had a higher
risk of CS than the multiparous, especially when labour was induced. The main indications
for CS were disproportion, poor progress of labour and non-reassuring fetal status (NRFS).
For women with one previous CS, with a CS rate of 80%, the leading cause for CS was
maternal request.
Conclusion: High CS rates among nulliparous is leading to an increase of women with
a previous scar, in which group the risk of another CS is substantial - a domino-effect. When
trying to lower CS rates, focus should be aimed at improving management of the nulliparous
women to avoid the first CS.
Key words: Caesarean section rate, Ten group classification system, main indication, KCMC,
Tanzania | eng |
