Maternal and neonatal outcomes of caesarean deliveries in a resource-limited tribal hospital in the Eastern Ghats of India.

Introduction: Caesarean sections (CSs) are an essential component of comprehensive emergency obstetric care to reduce maternal and neonatal mortality. The tribal population accounts for 8.4% (104 million) of the total population of India. Significant differences exist in CS rates between tribal and non-tribal women which remain poorly understood. We examined the indications, obstetric surgical techniques and outcomes of CS in a resource-poor tribal hospital located in the Eastern Ghats of India. Methods: This cross-sectional study included review of records maintained in this tribal hospital for the year 2022 (1 January-31 December 2022) with regard to the indications, surgical techniques and outcomes of CS. There were a total of 779 births in the year 2022. Results: Of the total births, 658 (84.5%) women belonged to the tribal community. The total number of CS was 112 (14.2%) in the study population, with a mean maternal age of 23.6±3.9 years. The mean gestational age was 38.3±3.2 weeks and the mean birth weight was 2.7±0.4 kg. An increased frequency of CS (Robson's Category 10) 14 (6.9%) was noted among multiparous women. A history of previous CS 59 (52.7%) was the most common indication across all age groups. Increased prevalence of (Robson's Category 10) CS was noted among women aged 20-24 years 7 (14.6%) and 25-29 years 7 (16.7%). Double-layer uterine closure was the most used surgical technique. Conclusion: The prevalence of CS in this tribal population was 14%. This study is among the first to evaluate obstetric surgical outcomes and classify caesarean deliveries using Robson's criteria in a tribal community. CS was more common among younger mothers and those with a previous CS. These findings provide baseline data for future comparative research and highlight the need for standardised adhesion quantification based on surgical technique, particularly in women with a previous CS.