The pattern of obstructed labour among parturients in a tertiary hospital in southern Nigeria

Abstract

Background: Obstructed labour is an obstetric entity which is almost never seen in the developed world but remains very prevalent in the developing world. This study aims to determine the pattern of obstructed labour in our environment as well as examine its contribution to perinatal and maternal morbidity and mortality.
Methods: This retrospective study was based on analysis of medical records of 116 cases of obstructed labour who presented for delivery at the Obstetrics Unit of the University of Port Harcourt Teaching Hospital, Nigeria, from 1st January, 2004 to December 31, 2008. Data collected from the records included patients' admission diagnosis, socio-demographic data, obstetric history and outcome. Data management was done using SPSS 15.0 for Windows® statistical software.
Results: The incidence of obstructed labour was 0.78%. All the patients were unbooked. Most of the parturients [65(66.4%)] were aged between 20-30 years while 57(58.8%) were nulliparous.  Fifty three (55.2%) had no formal education or primary education. Unemployed housewives, petty traders, hair dressers, seamstresses or farmers comprised 87.6% of the patients. Forty seven (47.4%) babies were stillborn. Twenty nine babies (29.9%) were admitted into the Special Care Baby Unit. Thirty nine babies (40.2%) were discharged home. The perinatal mortality rate was 597 per 1000 live births. Puerperal sepsis was the commonest maternal complication [30(30.8%)]. There were seven maternal deaths giving a case fatality ratio of 7216.5/100,000.
Conclusion: Obstructed labour, is still prevalent in our environment and contributes significantly to maternal and perinatal morbidity and mortality. Most of its victims are unbooked nulliparous ladies with poor socio-economic and educational backgrounds.

Keywords: Obstructed labour, Outcome, Antenatal care