Labour outcome in patients admitted in the second stage of labour at Jos University Teaching Hospital, Jos, Nigeria (original) (raw)
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Journal of Health, Medicine and Nursing, 2018
Maternal mortality is unacceptably high. About 830 women die from pregnancy or childbirth-related complications around the world every day. It was estimated that in 2015, roughly 303 000 women died during and following pregnancy and childbirth. Almost all of these deaths occurred in low-resource settings, and most could have been prevented. Admission of women in second stage of labour is often associated with poor maternal and fetal outcomes. These outcomes include: postpartum haemorrhage, obstructed labour and ruptured uterus. This study aimed to compare the birth outcomes among mothers presenting in Second Stage of labour with those who presented in First Stage of labour at Kakamega County Referral hospital. Specifically, it examined maternal outcomes and reasons why mothers presented in Second Stage of labour. A cross-sectional study using mixed methods approach was conducted in the study area. Systematic sampling technique was used to recruit the participants. Data was collected...
Birth outcome in patients presenting for hospital delivery in the second stage of labour
PubMed, 2013
Background: Even though women in labour are expected to be managed in the hospital under the care of an Obstetrician, a subset of women, who actually plan to have hospital delivery spent greater part of their labour at home without any medical assistance and only present to the labour room at full cervical dilatation. Aim and objectives: To compare the maternal and neonatal outcome in patients that present in the second stage of labour and those that present in the active phase of labour before full cervical dilatation. Patients and methods: This was a prospective case - control study comparing the maternal and neonatal outcomes of women who planned hospital delivery but presented to the labour ward of the University of Maiduguri Teaching Hospital at full cervical dilatation, following an unsupervised first stage at home. For each case, the next two patients that presented for delivery in the active phase of labour were used as controls. The study was conducted between 1st January 2013 to 31st December 2013 and only booked and low risk pregnancies were recruited. Independent sample t-test was used to compare continuous variables. For categorical data, Pearson's chi-square or Fisher's exact test was utilized for comparisons. A P value less than 0.05 was considered significant Results: The incidence of home labour was 11.54% (335/2902). The mean age, gestational age at delivery and birth weights were comparable in the 2 groups with p values of 0.724, 0.787 and 0.618 respectively. However, the parity and the estimated blood loss were significantly higher in the Home labour group compared to the Hospital labour group. Interventions such as augmentation of labour, episiotomy and caesarean delivery were higher among those that laboured in the hospital compared to those that laboured at home. However, post partum haemorrhage occurred in 6.3% of the Home labour group compared to 0.94% of the Hospital labour group and the differences were statistically significant. The neonatal outcomes were similar in the two groups. Conclusion: Our finding showed that women that present for hospital delivery in the second stage of labour have increased risk of post partum haemorrhage but the risk of labour augmentation, episiotomy and caesarean delivery is lowered. We advocate that women should be encouraged to present to the labour ward early in labour to avoid hasty delivery and risk post partum haemorrhage.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: The common complications occurring during third stage of labor are PPH Retained Placenta, Morbid adherent placenta- placenta accreta, placenta increta, percreta, perineal tears, uterine inversion increasing the maternal morbidity and mortality. The objective of the present study was to evaluate percentage and spectrum of obstetrics complication occurring during third stage of labor.Methods: An observational study was done at Department of Obstetrics and Gynecology, People’s College of Medical Sciences and Research Center, Bhopal from January 2016 to December 2017. All women delivering vaginally including instrumental deliveries were included. The medio-lateral episiotomy was given to all primigravida and for multigravida decision was case based as big size babies, instrumental deliveries, rigid perineum. Active management of third stage of labor was practiced.Results: 899 women delivered vaginally during the study period of 2 years (Jan -Dec 2016 Jan -Dec 2017). Among th...
Feto-maternal outcome of induced versus spontaneous labour in a Nigerian Tertiary Maternity Unit
Tropical Journal of Obstetrics and Gynaecology, 2017
background: Induction of labour may be associated with postpartum haemorrhage, instrumental delivery, blood transfusion, longer hospital stay and admission into neonatal intensive care unit. Objective: To assess the feto-maternal outcome of induced labour compared to spontaneous onset labour. Materials and Methods: Prospective comparative study involving 440 participants divided into induction (study) and spontaneous labour (control) groups. Data were collected on socio-demographic data, maternal complications, blood transfusion and neonatal outcomes. Results: A total of 1540 deliveries occurred during the study period, out of which 257 had induction of labour. Successful induction rate was 16.47%. Vaginal delivery was 67.6% in the study group compared to 83.4% in the control group. Postdated pregnancy and hypertensive diseases accounted for 56.8% and 28% of the indications for induced labour, respectively. Induced labour was associated with a significantly higher caesarean section rates (P < 0.001). Cephalo-pelvic disproportion was the most common indication for caesarean section (P = 0.038). Maternal complications include primary postpartum haemorrhage, perineal lacerations and endometritis. The study group had longer duration of hospital stay compared to the control (P < 0.001). Five perinatal mortality occurred among the study group compared to three in the control (P = 0.848). Conclusion: Induction of labour is associated with increased risk of caesarean delivery and postpartum haemorrhage compared with spontaneous labour, however, overall rates remain low.
Evaluation of complication during third stage of labour at tertiary care center
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: The objective of the present study was to determine the maternal outcome of complications of third stage of labour and to determine the risk factors and evaluate the management protocols for these complications.Methods: This is retrospective study of maternal outcome with complications of third stage of labour carried out at tertiary care centre from June 2016 to December 2019. Patients who developed any complications of third stage of labour after vaginal delivery or caesarean section were included.Results: Complications observed during third stage of labour were atonic PPH 0.82% (74 cases), traumatic PPH 0.55% (50 cases), retained placenta (including placenta accreta spectrum) 0.21% (19 cases), secondary PPH 0.03% (3 cases), uterine inversion 0.03% (3 cases) and amniotic fluid embolism 0.01% (1 case). Maximum cases were seen in 18-24 years of age group. Only 36% patients having atonic PPH responded to medical treatment, 46% patients having atonic PPH responded to conse...
Bima Journal of Science and Technology , 2023
Child delivery complications remain a public health challenge despite several efforts made by government and non-governmental organisations. Socio-cultural, economic and related health care services and logistics remains the most common factors responsible for these complications in Nigeria. This study, therefore, was undertaken to achieve the following objectives; to examine the problems pregnant women face attending antenatal care in Zainab Bulkachuwa Women and Children Hospital and examine the nature of child delivery complications among pregnant women in Zainab Bulkachuwa Women and Children Hospital. Furthermore, the study employed a descriptive research method and data was collected from a sample of 225 pregnant women from the population of 426 registered antenatal women during the study period using Krejcie and Morgan sample size calculator with 5% margin of error and 95% confidence level. The data was analysed using statistical package for the social sciences (version, 21). The findings of the study indicated that, pregnant women face problems such as waiting long time at the hospital and inadequate medical facilities they might needed during antenatal visits among other problems. Furthermore, the study found that, the complications women face includes haemorrhage, spontaneous abortion, obstructed labour, blood transfusion and caesarean section among others. Finally, the study outlines the strategies need to be followed in reducing child delivery complications among pregnant women in the hospital. These include provision of more health care facilities and drugs in the hospital, allowing traditional birth attendants to work in the hospital after training on hygiene and sanitation in and around the labour room and the pregnant woman as well as provision of free health care services to indigent women among others.
Maternal morbidity after childbirth in a health care facility in south - South Nigeria
Tropical journal of obstetrics and gynaecology, 2012
Background: Maternal morbidity though a global public health problem had not been a major Subject of emphasis like maternal mortality. And yet for each woman that dies sixteen others Suffer various forms of morbidity. Objective: This study was design to determine the incidence, types and determinants of maternal morbidity after childbirth in a health care facility in south-south Nigeria. Methodology: This study was a retrospective review of delivery records of women who were treated at the maternity unit of the Holy Family Hospital, Ikom, Cross-Rivers State, Nigeria from January 2004 to December 2010. Results: Among the 3,068 deliveries, 124(4.04%) women suffered various morbidities. Most (31.5%) were aged 26 to 30 years. Sixty seven (54.0%) had at least secondary level of education. About 38.0% had no occupation. Unbooked (53.2%) and Para 3 to 4 (54.0%) were in the majority. The leading morbidities were; postpartum heamorrhage (33.9%), retained placenta (25.0%), hypertensive disorders (14.5%) and genital sepsis (13.7%). Educated women were more likely to book for antenatal care (p=0.000) and to deliver in orthodox health facility (p=0.007).The morbidities were significantly related to the level of skill of the birth attendants (p=0.001) and place of delivery (P=0.045). Majority (85.5%) of the patients were treated as in-patients for a week. Conclusion: The incidence of maternal morbidity was high with postpartum haemorrhage, retained placenta, hypertensive disorders and genital sepsis as the leading morbidities. Sustaining the campaign for women education, utilization of reproductive health services, promoting the employment of skilled birth attendants and hospital delivery is recommended.
Caesarean delivery An experience from a tertiary institution in north western Nigeria.pdf
Objective: To assess the overall caesarean section (CS) rate, indications and outcomes in a tertiary hospital in North-western Nigeria. Materials and Methods: A cross-sectional study carried out over a period of two years. All patients who had caesarean section at any time within the day were noted and followed up till discharge. The socio-demographic data, types of CS, anaesthesia, indications, abdominal wall and uterine incisions, cadre of surgeon and feto-maternal outcomes were documented in a proforma. Statistical analysis was carried out using the EPI INFO 3.5.1 (CDC Atlanta Georgia, USA). Result: The caesarean section rate was 11.3% (504/4462) of total deliveries. The highest rate of 44.6% (225/504) was among the primipara. The most common age group involved was 25 to 29 years. The emergency rate was 57.1% (288/504), while elective CS constituted 42.9% (216/504) of cases. The most common indication for emergency CS was obstructed labour 25.7% (30/288) and previous CS 39.8% (86/216) for elective CS. The complication rate was 13.3% (67/504) and the main complication was haemorrhage 59.7% (40/67). Complications were more with emergency CS compared to elective surgery (χ 2 = 6.633, df = 1, P < 0.01) and with junior residents (χ 2 = 15.9, df = 1, P < 0.001). There were 10 maternal and 60 perinatal deaths. Conclusions: The rate of caesarean section has been increasing gradually. There is need to improve on facilities and manpower in order to reduce morbidity and mortality.
Induction of labour at Jos University teaching, hospital, Jos, Nigeria: a four year review
International Journal of Research in Medical Sciences, 2015
Background: Induction of labour (IOL) is a common procedure that remains a relevant Obstetric procedure. The maternal and perinatal outcomes are paramount hence the need to review the intervention in order to implement needed change. Objectives: To determine incidence, indications, outcome and complications of induction of labour at the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Methods: This was a retrospective study reviewing 584 women who had IOL in JUTH from January 2004 to December 2007. Parameters selected for review include parity, gestation age, outcome and cervical state prior to IOL. Results: Four hundred and eighty women had vaginal deliveries (82.2%). There were fifty two induced on account of antepartum Intra Uterine Foetal Deaths (IUFD), while 1.5% of the deliveries ended up as still births, 10.5% had birth asphyxia and neonatology review and care. Thirty two patients had various complications after IOL. There were no maternal mortalities. Conclusion: Parity and presence of IUFD were found to influence the outcome of IOL.
Open Journal of Obstetrics and Gynecology, 2021
Introduction: Prolonged Second Stage of Labor (SSL) is known to increase maternal and foetal morbidity. We, therefore, aimed to assess for the occurrence of complications of the SSL in relation to its duration in primiparous women in Yaounde. Methods: It was a cohort study carried out at the Yaounde Gynaeco-Obstetric and Paediatric Hospital over a period of 6 months, from December 19, 2018 through May 3, 2019. We included for the study nulliparous pregnant women with singleton pregnancies and normal uteri. Data collected were analysed using EPI info 7 and SPSS version 2.0 software. Results: Amongst 327 nulliparas, the SSL lasted more than one hour in 120 (36.7%), and more than two hours in 42 (12.8%). The most common maternal complications observed were genital lacerations (23.6%; 28/120), instrumental deliveries (20.2%, 24/120), post-partum haemorrhage (8.9%). Foetal complications included caput succedaneum (15.2%; 18/120) and perinatal asphyxia (7.5%; 9/120). Maternal complications were significantly increased in women with an SSL lasting 1-2 hours (44.9% versus 22.7%; p < 0.001) and >2 hours (42.9% versus 22.7%; p = 0.007). Similarly, for foetal complications 23.1% occurred with SSLs between 1-2 hours (versus 6.3%; p < 0.001) and 19.0% for SSLs > 2 hours (versus 6.3%; p = 0.007). Conclusion: Maternal and foetal complications increase when the SSL exceeds 1 hour in primiparas. Identifying factors that predispose to a prolonged SSL and indicating appropriate interventions could help prevent morbidity.