DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20212937

Obstructed labour in a Nigerian tertiary health facility: a mixed-method study

Akaninyene Eseme Ubom, Omotade Adebimpe Ijarotimi, Ifeoluwa Emmanuel Ogunduyile, Ayobami Omilakin, Solomon Nyeche, Emeka Philip Igbodike, Ogunjide Olakunle Emmanuel, Ernest Okechukwu Orji, John Igemo Ikimalo, Adebanjo Babalola Adeyemi

Abstract


Background: Obstructed labour remains a leading cause of maternal and perinatal mortality and morbidity in sub-Saharan Africa. This study aimed to determine the incidence, causes, complications and outcomes of obstructed labour at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun state, Nigeria.

Methods: A mixed methods approach was employed for this study. A 10-year retrospective review of all cases of obstructed labour managed at the OAUTHC, between January 1, 2008, and December 31, 2017, was done. Ten in-depth interviews were conducted for some selected patients. The quantitative data was analysed using SPSS version 24, while the qualitative data was analyzed with NVivo version 12.

Results: The incidence of obstructed labour was 1.99%. Most of the patients were unbooked (217, 90.4%), primigravid (138, 57.5%), and either had no formal or only primary/secondary education (120, 50%). Cephalopelvic disproportion (CPD) was the commonest cause of obstructed labour (227, 94.6%). The most common maternal complication was wound infection (48, 20%). There were three maternal deaths, giving a case fatality rate of 1.25%. The most common foetal complication was birth asphyxia (85, 34.7%). The perinatal mortality rate was 18.8 %. From the qualitative arm of the study, reasons given by parturients who suffered obstructed labour, for avoiding hospitals for delivery, included religion, finance, fear of hospitals, faith/belief in mission homes/maternity houses, and proximity.

Conclusions: Obstructed labour remains an important obstetric problem in our environment, contributing significantly to the burden of maternal and perinatal mortality and morbidity.

 


Keywords


Maternal morbidity, Maternal mortality, Obstructed labour, Perinatal morbidity, Perinatal mortality, Nigeria

Full Text:

PDF

References


Islam JA, Ara G, Choudhury FR. Risk Factors and Outcome of Obstructed Labour at a tertiary care Hospital. J Shaheed Suhrawardy Med Coll. 2012;4(2):43-6.

Kiran A, Singh RR, Sinha AN, Srinagar UI. A clinical study of 100 cases of Obstructed Labour and its Fetomaternal Outcome. JBLS. 2015;6(2):141-7.

Rizvi SM, Gandotra N. Maternofetal outcome in obstructed labour in a tertiary care hospital. Int J Reprod Contracept Obstet Gynaecol. 2015;4(5):1410-13.

Fasubaa OB, Ezechi OC, Orji EO, Ogunniyi SO, Akindele ST, Loto OM et al. Delivery of the impacted head of the fetus at caesarean section after prolonged obstructed labour: a randomized comparative study of two methods. J Obstet Gynaecol. 2002;22(4):375-8.

Abasiattai AM, Bassey EA, Etuk SJ, Udoma EJ. The Pattern of Obstructed Labour in Uyo, South-Eastern Nigeria. Trop J Obstet Gynaecol. 2006;23(2):146-9.

Jeremiah I, Nwagwu V. The pattern of obstructed labour among parturients in a tertiary hospital in southern Nigeria. Port Harcourt Med J. 2012;6(1):44-55.

Nwobodo EI, Ahmed Y. Obstructed labour: A public health problem in Sokoto, Nigeria. Sahel Med J. 2011;14(3):140-2.

Melah GS, El-Nafaty AU, Massa AA, Audu BM. Obstructed labour: a public health problem in Gombe, Gombe state, Nigeria. J Obstet Gynaecol. 2003;23(4):369-73.

Aboyeji AP, Fawole AA. Obstructed labour in Ilorin, Nigeria: a one-year prospective study. Nig Med Pract. 1999;38:25-8.

Sharma P, Kumari K, Kanti V, Seth S. Obstructed Labour: A preventable tragedy but still a long way to go in developing countries. Int J Health Sci Res. 2015;5(9):99-104.

Ara A. Outcome of obstructed labour. JPMI. 2011;18(3):512-7.

Henok A, Asefa A. Prevalence of Obstructed Labour among Mothers Delivered in Mizan-Aman General Hospital, South West Ethiopia: A Retrospective Study. J Women’s Health Care. 2015;4(5):250.

Olusanya O, Okpere EE, Ezimokhai M. Scoring system for social class. West Afr J Med. 1995;4:4.

Shaikh S, Shaikh AH, Shaik SAH, Isran B. Frequency of Obstructed Labour in Teenage Pregnancy. NJOG. 2012;7(3):37-40.

Agbata AT, Eze JN, Ukaegbe CI, Odio BN. A 4-year retrospective review of stillbirths at the Federal Teaching Hospital, Abakaliki, Southeast Nigeria. Afr J Med Health Sci. 2017;16:19-24.

Chigbu B, Onwere S, Kamanu CI, Aluka C, Okoro O, Adibe E. Pregnancy outcome in booked and unbooked mothers in South-Eastern Nigeria. East Afr Med J. 2009;86(6):267-71.

Daniel CN, Singh S. Caesarean delivery: An experience from a tertiary institution in North Western Nigeria. Niger J Clin Pract. 2016;19(1):18-24.

Okunade KS, Okunola H, Oyeneyin L, Habeeb-Adeyemi FN. Cross-sectional study on the obstetric performance of primigravidae in a teaching hospital in Lagos, Nigeria. Niger Med J. 2016;57(5):303-6.

Bimbola KO. Obstructed labour: The main cause of vesico-vaginal fistula-Review of literature. EJRMS. 2014;2(1):1-7.

Kabakyenga J, Östergren PO, Turyakira E, Mukasa PK, Petterson KO. Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda. BMC Pregnancy Childbirth. 2011;11(1):73.