The changing pattern of obstructed labour in Lagos

Abstract

Background: Obstructed labour is still a major cause of maternal mortality and morbidity and of adverse perinatal outcome in developing countries.

Objectives: To determine the incidence, pattern of presentation, source of referral, complications, maternal and perinatal mortality and morbidity from obstructed labour as seen in a university teaching hospital.

Methods: A longitudinal descriptive study of all cases of obstructed labour managed at Ayinke House; the Obstetric and Gynecology unit of the Lagos State University Teaching Hospital (LASUTH) Ikeja, between January 2007 and December 2008 was carried out

Results: There were 7,470 deliveries during the study period and 316 of these were complicated by obstructed labour giving an incidence of 4.2%. Of the 316 women, 189 (59.8%) were nullipara. One hundred and eleven cases (35.1%) with obstructed labour were booked in LASUTH, while the remainder were unbooked. Cephalopelvic disproportion was the commonest cause of obstruction and accounted for 69.6% of cases and lower segment cesarean section was the most common intervention. Most of the women (42.4%) were in occupational social class IV. The leading complication of obstructed labour was wound infection/ puerperal sepsis accounting for 18.7% of cases There were 15(4.7%) maternal deaths giving a maternal mortality ratio of 1,415 /100,000 and perinatal mortality was 19.9%.

Conclusion: Obstructed labour remains one of the leading causes of maternal mortality in this centre with majority being booked for antenatal care.

Keywords: obstructed labour, new trend, maternal morbidity and mortality