Risk Factors and Outcome of Obstructed Labour at a tertiary care Hospital

Abstract

Background: Obstructed labour is one of the most common preventable cause of maternal and prenatal morbidity and mortality in developing countries. Objective: The purpose of the present study was to determine the risk factors as well as to asses the outcome of obstructed labour. Method: This cross sectional study was conducted in the Department of Gynecology & Obstetrics at Shaheed Ziaur Rahman Medical College Hospital, Bogra during the period from January 2007 to December 2007. 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. DOI: http://dx.doi.org/10.3329/jssmc.v4i2.14401 J Shaheed Suhrawardy Med Coll, 2012;4(2):43-46

Maternal and Perinatal Outcome in Obstructed Labour

“…In the present study CPD was the most leading cause of obstruction comprising 54.4% 0f cases which is comparable Dafallah et al Neena chuni (2008) and Shimelis et al (2010). [5][6][7] Malpresentation and malposition have taken together contributed 42% of cases in the present study which is similar to the incidence of 45.4% and 50.5% as reported by Neena chuni (2008) and Islam et al (2012). [6,8] In the present study caesarean section was done in 80.4% of cases which is comparable with the Neena chuni (2008) series where CS was done in 82.1% of cases.…”

“…[5][6][7] Malpresentation and malposition have taken together contributed 42% of cases in the present study which is similar to the incidence of 45.4% and 50.5% as reported by Neena chuni (2008) and Islam et al (2012). [6,8] In the present study caesarean section was done in 80.4% of cases which is comparable with the Neena chuni (2008) series where CS was done in 82.1% of cases. [6] In the modern era, CS under good antibiotics coverage has a very low morbidity and mortality and it is the best option.…”

“…Birth asphyxia is the frequent and foremost cause of neonatal mortality. In the present study, the perinatal death rate was 19.12% comparable with 27.1% in Dafallah et al (2003) and 22.8% in Islam et al (2012) series. [5,7] However, it is quite less as compared to reported in Neena Chenu series in 2008 as 58%.…”

Sociodemographic Profile and Clinical Outcome of Obstructed Labour.

“…Majority of the patients were primigravidas (49.2%) comparable to the study of Anjum Ara (1996) 10 where 40.8% patients of obstructed labour were primigravidas. Majority were from rural areas (87.5%) comparable to the findings of Islam JA et al( 2012) 11 who reported 88% from rural areas. Majority were either illiterate or with only primary education (66.7%) comparable to highest incidence in low education patients (87%) in the study of Islam JA et al (2012) 11 .…”

“…Majority were from rural areas (87.5%) comparable to the findings of Islam JA et al( 2012) 11 who reported 88% from rural areas. Majority were either illiterate or with only primary education (66.7%) comparable to highest incidence in low education patients (87%) in the study of Islam JA et al (2012) 11 . Most patients were unbooked (52.5%) comparable to 63.8% in the study of Saad E Dafallah et al (2003) 9 .…”