International Journal of Innovative Research and Development

Abstract

Background: Despite advances in the reduction of maternal morbidity and mortality in the developed world, obstructed labor is still a major cause of prenatal mortality, morbidity, and one of the preventable causes of maternal morbidity and mortality in developing nations. Africa, most particularly sub-Saharan region has the highest morbidity and maternal mortality in the world. Though exact figure underestimated, WHO estimate at an average of about 1,000 deaths per 100,000 live births.This study aims to determine the pattern of obstructed labor in our environment, to investigate the role of individual and health facility factors, socio-economic impact, as well as examine its contribution to perinatal and maternal morbidity and mortality in South-South Nigeria  

Methods: A retrospective hospital-based, cross-sectional study of medical records of 141 Cases of obstructed labour was carried out in all pregnant women who were admitted and delivered in the labor ward of Niger Delta University Teaching Hospital from the 1^st. of January 2009 to 31^st. December 2013. The data used were collected based on questionnaire and checklist of the information analyzed. We implore the EPI info version 7.1.4.0

Result:

Over a five year period between (2009-2013) 141 cases of obstructed labour were recorded while 2,815 deliveries were conducted giving an incidence of 5.0%. The minority the patients (22.9) were primigravidae, the mean number of delivery in the study was 2.1±2.2 std. children. Abdominal massage during pregnancy prior to admission was (65.2%).Patronage of traditional birth attendant (TBA) places before presentation was (62.9%) and different forms of delay was noticed in (70.21%). The incidence of obstructed labour was much higher for the unbooked patients (75.7%) than for the booked.  Cephalopelvic disproportion was the greatest cause of obstructed labour (73.05%), while Caesarean section was the main method of delivery (87.1%). The leading complications of obstructed labour were postpartum haemorrhage (62.41%) followed by puerperal sepsis (49.65%), patient with anemia on admission before surgeries/delivery (53.192%), uterine rupture (20.57%), injury to the bladder (12.77%) and genital tract laceration (2.8%). All patients received antibiotic therapy, while there were thirty still births giving perinatal mortality rate was 212 per 1000 live births.  There were two maternal deaths giving a case fatality ratio of 14 per 1000 delivery.

Conclusion: The complications caused by the obstructed labor was very high, so the incidence, it was also noticed that large proportion of the patients are un-booked, and primarily visited traditional birth attendance places, or underwent abdominal massage prior to presentation. The antenatal care follow-up practice was also found to be low. Improvement of our antenatal care coverage, good referral system, adequate governmental support, good education, and empowerment of the female child and availing comprehensive obstetric care in nearby health institutions are better tools recommendable to prevent or reduce obstructed labor and its complications.

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Abstract

Background: Despite advances in the reduction of maternal morbidity and mortality in the developed world, obstructed labor is still a major cause of prenatal mortality, morbidity, and one of the preventable causes of maternal morbidity and mortality in developing nations. Africa, most particularly sub-Saharan region has the highest morbidity and maternal mortality in the world. Though exact figure underestimated, WHO estimate at an average of about 1,000 deaths per 100,000 live births.This study aims to determine the pattern of obstructed labor in our environment, to investigate the role of individual and health facility factors, socio-economic impact, as well as examine its contribution to perinatal and maternal morbidity and mortality in South-South Nigeria  

Methods: A retrospective hospital-based, cross-sectional study of medical records of 141 Cases of obstructed labour was carried out in all pregnant women who were admitted and delivered in the labor ward of Niger Delta University Teaching Hospital from the 1^st. of January 2009 to 31^st. December 2013. The data used were collected based on questionnaire and checklist of the information analyzed. We implore the EPI info version 7.1.4.0

Result:

Over a five year period between (2009-2013) 141 cases of obstructed labour were recorded while 2,815 deliveries were conducted giving an incidence of 5.0%. The minority the patients (22.9) were primigravidae, the mean number of delivery in the study was 2.1±2.2 std. children. Abdominal massage during pregnancy prior to admission was (65.2%).Patronage of traditional birth attendant (TBA) places before presentation was (62.9%) and different forms of delay was noticed in (70.21%). The incidence of obstructed labour was much higher for the unbooked patients (75.7%) than for the booked.  Cephalopelvic disproportion was the greatest cause of obstructed labour (73.05%), while Caesarean section was the main method of delivery (87.1%). The leading complications of obstructed labour were postpartum haemorrhage (62.41%) followed by puerperal sepsis (49.65%), patient with anemia on admission before surgeries/delivery (53.192%), uterine rupture (20.57%), injury to the bladder (12.77%) and genital tract laceration (2.8%). All patients received antibiotic therapy, while there were thirty still births giving perinatal mortality rate was 212 per 1000 live births.  There were two maternal deaths giving a case fatality ratio of 14 per 1000 delivery.

Conclusion: The complications caused by the obstructed labor was very high, so the incidence, it was also noticed that large proportion of the patients are un-booked, and primarily visited traditional birth attendance places, or underwent abdominal massage prior to presentation. The antenatal care follow-up practice was also found to be low. Improvement of our antenatal care coverage, good referral system, adequate governmental support, good education, and empowerment of the female child and availing comprehensive obstetric care in nearby health institutions are better tools recommendable to prevent or reduce obstructed labor and its complications.

Keywords

Full Text