STUDY ON CESAREAN-SECTION IN ZANZIBAR

In the period from the lst June 1989 to 31st March 1991, there were 81 62 deliveries in Mnazi Mmoja Hospital in Zanzibar, of which 190 were h y caesarean section, a rate of 2.33%. Of these, 90 (4.57%) were primig ravida. The indication for caesarean section was compared between grou ps of primigravida and mutipara with three common indications-dystocia (78.9%), breech (5.5%), foetal distress (5.5%) in primigravida, and f our common-dystocia (37%), placenta previa (19%), repeat section (17%) , transverse lie (12%) in the multiparas. A comparison of perinatal de ath and maternal complications was made on three groups (primigravida, multipara 2-7, multipara 8 or more). Perinatal mortality rate (PNMR) was 178.57%, in which significant difference between the groups of pri migravida and multipara 8 or more was observed (P<0.01). Maternal mort ality was 31.58%. It is suggested that active management of labour lea d to a decrease in the rate of caesarean section due to dystocia in nu lliparas, and great attention should be paid to the early detection an d prompt treatment of dystocia in multiparas.