Obstructed labour in Enugu, Nigeria (original) (raw)
Related papers
Incidence, causes and outcome of obstructed labor in jimma university specialized hospital
Ethiopian Journal of Health Sciences, 2011
BACKGROUND: Obstructed labor is one of the common preventable causes of maternal and perinatal morbidity and mortality in developing countries. Africa has t he highest maternal mortality in the world, estimated at an average of about 1,000 deaths per 100,000 live births. This study was conducted to assess the incidence, causes and outcome of obstructed labor in Jimma University Specialized Hospital. MET HODS: Hospital-based, cross-sectional study was conducted on all mothers who were admitted and delivered in the labor ward of Jimma University Specialized Hospita l from November 1, 2008 to April 30, 2009. Data was collected using structured questionnaire and checklist, and then analyzed using SPSS for windows version 16.0. RES ULTS: The incidence of obstructed labor was 12.2%. Out of these 61.5% did not have antenatal care followup. Most of the cases, accounting for 145(81.0%), 160 (89.4%) and 170 (93.9%) were referred from health centers, visited the hospital after at least 12 hours of labor and came from a distance of more than 10 kilometers, respectively. The causes of obstructed labor were cephalo-pelvic disproportion in 121(67.6%) and malpresentation in 50 (27.9%) of the cases. The commonest maternal complications observed were uterine rupture in 55 (45.1%) and sepsis in 48 (39.3%) of the cases with complications. Forty-five point eight percent of fetuses were born alive and all had low first minute APGAR score. CONCLUS ION: The incidence of obstructed labor was high with high rate of complications. The antenatal care follow-up practice was also found to be low. Improved antenatal care coverage, good referral system, and availing comprehensive obstetric care in nearby health institution are recommended to prevent obstructed labor and its complications.
Maternofetal outcome in obstructed labour in a tertiary care hospital
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2015
Background: Obstructed labour is still a major cause of maternal morbidity and mortality and adverse outcome of newborn in low income countries. It is the leading cause of hospitalization, comprising of 39% of all obstetric patients in developing countries. Objectives: To study frequency, causes outcome and complications of obstructed labour. Methods: 402 patients admitted with feature of obstructed labour were studied. Detailed history included sociodemographic factors, obstetric history, features of obstruction, intrapartum events were recorded. Condition of patients, mode of delivery, preoperative and postoperative complications, maternal and fetal outcomes was recorded. Results: A total of 23381 deliveries were conducted during one year, 402 cases of obstructed labour were found with incidence of 1.71%. 86.5 % of the patients were from rural areas and 78.1 % of patients were unbooked and73.3% patients were primigravida. The commonest cause of obstructed labour was cephalopelvic disproportion (55%) followed by Malposition (22.9%) and Malpresentation (17.9%). The commonest mode of delivery was cesarean section (83.8%). Instrumental deliveries were conducted in 10.5% of cases. Destructive procedures are discouraged in out set up. Rupture uterus was seen in 16 cases (4.16%) out of which repair was done in 11 cases and subtotal hysterectomy was performed in 5 patients. The common maternal complications were sepsis [pyrexia (15.1%), wound infections (12.8%), urinary tract infection (7%), abdominal distention (11.2%), postpartum hemorrhage (9.7%). Perinatal mortality was 107/402 (26.6%), live birth rate 316/402 (78.7%), still birth rate 86/402 (21.3%). Perinatal morbidity was most commonly due to birth asphyxia (28.8%), jaundice (16.9%), septicemia (14.75%), meconium aspiration syndrome (9.9%). Conclusions: Obstructed labour is a preventable condition prevalent in developing countries. Improving nutrition, antenatal care, early diagnosis and timely intervention may result in decrease in incidence of morbidity and mortality.
Maternal and Fetal Outcome in Obstructed Labour
Background: Obstructed labour continues to be a major cause of maternal and perinatal morbidity in low income countries even in 21 st century. If detected and managed early, which will give a healthy mother and baby. Materials and Methods: 90 patients admitted with feature of obstructed labour were studied. Detailed history included age, antenatal checkup , sociodemographic factors, referral history, obstetric history, features of obstruction, intrapartum events were recorded. Condition of patients, mode of delivery, preoperative and postoperative complications, maternal and fetal outcomes was recorded. Results: Out of 90 cases of Obstructed labour, majority of the patients were from low (82.2%) socioeconomic group, 80% of the patients were from rural areas and 76.7% of patients were unbooked and 62.2% patients were primigravida. The commonest cause of obstructed labour was cephalopelvic disproportion (67.8%) followed by Malpresentation & Malposition (17.8%). The commonest mode of delivery was cesarean section (86%). Instrumental deliveries were conducted in 2% of cases. Destructive procedures were done in 2%. Rupture uterus was seen in 4 cases (5.7%) out of which repair was done in all 4 cases. The common maternal complications were PPH (50.0%), pyrexia (28.5%), genital tract sepsis (8.6%), shock (4.3%) and vesico-vaginal fistula (2.9%). Perinatal mortality was 4/90 (4.4%) and livebirth rate was 86/90 (95.6%). Perinatal morbidity was most commonly due to birth asphyxia (61.6%), meconium aspiration syndrome (19.2%), jaundice (15.4%) and septicemia (3.8%). Conclusion: Poor referral system, low socioeconomic status and inadequate antenatal care services lead to increased number of obstructed labour even today. Early recognition of obstructed labour and immediate safe abdominal or vaginal delivery can decrease the incidence of maternal and perinatal morbidity and mortality
Tropical Journal of Obstetrics and Gynaecology, 2016
Results: Of the 617 total deliveries, 156 (25.3%) were admitted in second stage of labour. Majority of women (38.57%), (10.00%), (8.57%) stated transportation difficulties, fast progress of labour and husband not around respectively as the reason for coming in second stage of labour. Maternal complications like lower genital laceration (25.7% vs 8.6%), postpartum haemorrhage (7.1% vs 2.1%), and ruptured uterus (2.1%) were more common amongst the cases than the control. The total mean blood loss was similar in both groups. Complications of sickle cell crises, eclampsia, and anaemia including chorioamnionitis were found only among the cases. There were more spontaneous vagina deliveries amongst the cases while caesarean section and use of episiotomy were more amongst the control (P < 0.01). Instrumental delivery was similar in the two groups. Perinatal complications like fresh stillbirths (5.0%), early neonatal deaths (2.10%), birth asphyxia (5.4% vs 3.6%) and the need for admissions in special care baby unit (3.4% vs 0.7%) were more amongst the cases than the control. Conclusions: This study identified transportation problems, fast progress of labour, absence of husband at home when labour starts as major reasons for presenting in second stage of labour. Presenting in second stage of labour was associated with worse labour outcome.
Introduction: Obstructed labor continues to plague thousands of women each year, accounting for about 8% of all maternal deaths in developing countries like India. It is the leading cause of hospitalization, comprising up to 39% of all obstetric patients in developing countries. Obstructed labor is the single most important cause of maternal death and is one of the three leading causes of perinatal mortality with the case fatality rate of 87%-100%. Jharkhand. All patients admitted with obstructed labour were included in the study. Detailed history regarding age, socioeconomic status, parity, previous obstetric history, past history, antenatal care, duration of labour, details of referral and management were recorded. During admission, the general condition of mother was assessed as well as fetal lie, presentation, position and heart sounds were recorded. Results: During the one year study period, there were total of 8456 deliveries of which 145 cases were diagnosed to have obstructed labour, incidence being 1.71%. Maximum cases were in age group of 19-24 years (64.4%). 86.5% of the patients were from rural areas and 78.2% of the patients were unbooked. The commonest cause of obstructed labour was cephalopelvic disproportion (55%). Other causes were Malposition (22.9%), Malpresentation (17.9%), foetal congenital abnormality (1.38%), Myomas (0.83%), others (0.83%). 4 (1.11%) cases of previous caesarean section came in advanced stage of obstructed labour and resulted in rupture uterus. Conclusion: Obstructed labour continues to be a major cause of maternal and perinatal morbidity in low income countries and accounts for approximately 8% of maternal deaths globally. The common mode of delivery is by caesarean section. Poor referral system, low socioeconomic status, inadequate antenatal care services lead to many cases of obstructed labour. They are further compounded by poor road connectivity resulting in delayed specialized care.
TAJ, 2022
Introduction: Obstructed labour is one of the major causes of maternal mortality (8%) in Bangladesh. It is also responsible for high rate of maternal and fetal morbidity, if we can identify causes of obstructed labour, determine the outcome & complications in our country it may be helpful to find out the way to prevent this disease. Objective: The purpose of the present study was to determine the risk factors as well as to assess the outcome of obstructed labour. Methods: This study is a prospective observational study has been done in Department of Obstetrics and Gynaecology in Rajshahi Medical College Hospital, Rajshahi, Bangladesh during July 2016 to December 2018. Hundred patients who were admitted with obstructed labour during study period were included in this study. A detailed history included socio-demographic feature, obstetric history, features of obstruction, intrapartum events were recorded to detect risk factors. Condition of patients, mode of delivery, preoperative and postoperative complications, maternal and fetal outcomes were recorded. Results: This study was one hundred (100) cases with features of obstructed labour were selected. The highest frequency was found among the unbooked, primigravid patients that were illiterate or only having primary education level. 84% in primi-gravidae and 10% in multi gravidae had come from medium socioeconomic group and only 2% in case of primigravidae came from good economic classes. Revealed that 56% in primigravidae and 68% in multi gravidae of study population did not cross primary education level. the causative factors of obstructed labour, 46% in primigravidae and 42% multi gravidae cases were due to cephalopelvic disproportion with varying degrees of contracted pelvis, 52% in primigravidae and 58% multi gravidae cases caused by malpositions and malpresentations, 2% in primigravidae was due to cervical fibroid. The medical causes of obstructed labour in the study population were cephalopelvic disproportion 42-46%. One patient died due to post-partum hemorrhage among 10(10.0%) cases. Conclusion: In this study the incidence of obstructed labour was very high. The commonest cause was cephalopelvic disproportion followed by fetal malpostion and malpresentation.
Maternal outcome in obstructed labour in patients presenting to Nishtar Hospital Multan
The Professional Medical Journal
Objective: The objective of the study was to determine the frequency of maternal outcome in obstructed labour. Study Design: Descriptive Case Series. Setting: Labour Ward of Nishtar Hospital Multan, Pakistan. Period: 01-11-2018 to 30-04-2019. Material & Methods: Two hundred and forty two clinically diagnosed cases of obstructed labour admitted in labour ward of Nishtar Hospital Multan were enrolled for the study. Patients were monitored till delivery (vaginal/caesarean section) and complication of pregnancy were assessed till six week postpartum. Outcome variables i.e. complications like sepsis, uterine rupture, bladder rupture, vesicovaginal fistula, postpartum haemorrhage, and mortality was noted. Data was analyzed by using SPSS version 10.0. Results: The majority of women was in age group 20-29 years i.e. 42.97% and were primigravida. Sepsis was the most frequent maternal complication observed i.e. in 22.31% of cases. Postpartum haemorrhage was next in line i.e. in 19.42% of case...
SOCIODEMOGRAPHIC PROFILE AND CLINICAL OUTCOME OF OBSTRUCTED LABOUR.
Background: Obstructed labour is the condition that results from failure of descent of the fetal presenting part in the birth canal for mechanical reasons inspite of good uterine contractions. It remains an important cause of maternal and perinatal morbidity and mortality in developing countries. Materials and Methods: A hospital based cross sectional study was conducted over a period of one and a half years in which 120 cases of obstructed labour were evaluated after applying preselected inclusion and exclusion criteria. Detailed history including that of sociodemographic profile, medical history and obstetric history was taken from every patient. Maternal outcome in the form of mode of delivery and complications was noted. Fetal condition was also evaluated. Results: The study revealed that obstructed labour was common in illiterate women mostly from rural areas (87.5%) of low socioeconomic status (88.4%). Majority were primigravidas (49.2%) with mean age 30.5+3.29 . Most cases were due to cephalopelvic disproportion (62.5%). Majority were delivered by caesarean section(87.5%).The most common complication was abdominal distension(51.7%) followed by postpartum hemorrhage(37.5%).There was no maternal death. There were 108 live births(90%) out of which 8 (7.4%) died in neonatal period. Obstructed labour was a significant cause of low apgar scores at 5 minutes of birth(34.2%). Conclusion: Obstructed labour is still a great contributor of maternal and perinatal mortality in developing world. Sociodemographic and health facility factors were strongly associated with the outcome. Our aim should be universal and inexpensive good obstetric care to avoid it and prompt diagnosis and timely intervention in established cases to improve the outcome.
Risk Factors and Outcome of Obstructed Labour at a tertiary care Hospital
Journal of Shaheed Suhrawardy Medical College, 2013
Background: Obstructed labour is one of the most common preventable cause of maternal and prenatal morbidity and mortality in developing countries. . One hundred and five cases with features of obstructed labour were selected as per inclusion and exclusion criteria in a consecutive method. A detailed history included sociodemographic feature, obstetric history, features of obstruction, intrapartum events were recorded to detect risk factors. Condition of patients, mode of delivery, preoperative and post operative complications, maternal and fetal outcomes were recorded. Results: A total number of 3171 deliveries were conducted during this period and 132 cases of obstructed labour were found constituting an incidence of 4.2%. The highest frequency was found among the unbooked, primigravid patients that were illiterate or only having primary education level. The commonest cause was cephalo-pelvic disproportion (47.5%) followed by fetal malpostion (25.7%) and malpresentation (24.8%). The majority of the patients were between 25-29 years, caeserean section was the most common mode of delivery (78.09%). Maternal morbidity due to different complication accounted for 76.19% of the case while the fetal morbidity was 51.31% of the cases. The maternal mortality was 1% and prenatal mortality was 24.76%. Conclusion: In this study the incidence of obstructed labour was very high. The commonest cause was cephalo-pelvic disproportion followed by fetal malpostion and malpresentation.
PLOS ONE
Background Globally, obstructed labour accounted for 22% of maternal morbidities and up to 70% of perinatal deaths. It is one of the most common preventable causes of maternal and perinatal mortality in low-income countries. However, there are limited studies on the determinants of obstructed labor in Ethiopia. Therefore, this study was conducted to assess determinants and outcomes of obstructed labor among women who gave birth in Hawassa University Hospital, Ethiopia. Methods A hospital-based case-control study design was conducted in Hawassa University Hospital among 468 women. All women who were diagnosed with obstructed labour and two consecutive controls giving birth on the same day were enrolled in this study. A pretested data extraction tool was used for data collection from the patient charts. Multivariable logistic regression was employed to identify determinants of obstructed labor. Results A total of 156 cases and 312 controls were included with an overall response rate o...