Obstetric Emergencies in a Tertiary Hospital in Lagos, Nigeria

Abstract

Background: Emergency obstetric care (EMOC) remains a challenge to the health system in developing countries due to inadequate  resources. High-quality EMOC continues to be a vital element for reducing maternal mortality from direct causes. In developing countries with high maternal mortality ratios, the study of obstetric emergencies can help improve effective distribution of healthcare resources and the quality of EMOC.
Aim: This study aims to determine incidence and trends in obstetric emergencies at the Lagos University Teaching Hospital (LUTH).
Methods: This was a retrospective descriptive crosssectional study of obstetric emergencies at the LUTH over a 5-year period, from 1st May 2008 to 30th April 2013. The labour ward database and the medical records of subjects managed as a case of obstetric emergency were reviewed. For each subject, relevant information was obtained using a structured questionnaire.
Results: Of the 10,169 deliveries during the study period, 1266 (12.4%) had obstetric emergencies. The annual incidence rate of  obstetric emergencies increased from 9.4% in the first year to 15% in the fifth year. Labour dystocia was the commonest obstetric emergency (20.7%) followed by severe preeclampsia/eclampsia (19.7%), suspected fetal distress (17.1%) and obstructed labour (10.5%).
Majority (98.1%) of the parturient required emergency surgical intervention. At delivery, the median gestational age of subjects was 38 weeks with a range of 24 weeks to 42 weeks.
Conclusion: Obstetric emergency is a common occurrence among parturients at LUTH. The incidence of obstetric emergency has  increased over the years with a great proportion due to problems associated with progress of labour and childbirth, hypertensive disorders, and suspected fetal distress.

Key words: Emergency obstetric care, hypertension in pregnancy, ruptured uterus, fetal distress, labour dystocia,