Maternofetal outcome in obstructed labour in a tertiary care hospital


  • Syed Masuma Rizvi Associate Professor, Department of Obstetrics & Gynaecology, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Nikita Gandotra Resident, Department of Obstetrics & Gynaecology, Government Medical College, Srinagar, Jammu and Kashmir, India



Obstructed labour, Cephalopelvic disproportion, Perinatal mortality


Background: Obstructed labour is still a major cause of maternal morbidity and mortality and adverse outcome of newborn in low income countries. It is the leading cause of hospitalization, comprising of 39% of all obstetric patients in developing countries. Objectives: To study frequency, causes outcome and complications of obstructed labour.

Methods: 402 patients admitted with feature of obstructed labour were studied. Detailed history included sociodemographic factors, obstetric history, features of obstruction, intrapartum events were recorded. Condition of patients, mode of delivery, preoperative and postoperative complications, maternal and fetal outcomes was recorded.

Results: A total of 23381 deliveries were conducted during one year, 402 cases of obstructed labour were found with incidence of 1.71%. 86.5 % of the patients were from rural areas and 78.1 % of patients were unbooked and73.3% patients were primigravida. The commonest cause of obstructed labour was cephalopelvic disproportion (55%) followed by Malposition (22.9%) and Malpresentation (17.9%). The commonest mode of delivery was cesarean section (83.8%). Instrumental deliveries were conducted in 10.5% of cases. Destructive procedures are discouraged in out set up. Rupture uterus was seen in 16 cases (4.16%) out of which repair was done in 11 cases and subtotal hysterectomy was performed in 5 patients. The common maternal complications were sepsis [pyrexia (15.1%), wound infections (12.8%), urinary tract infection (7%), abdominal distention (11.2%), postpartum hemorrhage (9.7%). Perinatal mortality was 107/402 (26.6%), live birth rate 316/402 (78.7%), still birth rate 86/402 (21.3%). Perinatal morbidity was most commonly due to birth asphyxia (28.8%), jaundice (16.9%), septicemia (14.75%), meconium aspiration syndrome (9.9%).

Conclusions: Obstructed labour is a preventable condition prevalent in developing countries. Improving nutrition, antenatal care, early diagnosis and timely intervention may result in decrease in incidence of morbidity and mortality. 


Ammanuel Gessessew, Mengiste Mesfin. Obstructed labour in Adigrat Zonal Hospital, Tigray region, Ethiopia, Ethiop. Health Dev. 2003;17(3):175-80.

Cron J. Lessons from the developing world: Obstructed labor and the vesico-vaginal fistula. Med Gen Med. 2003;5:24.

Mekbib T, Kassaye E, Getachew A, Tadesse T, Debebe A. The FIGO save the Mothers Initiative: The Ethiopia-Sweden collaboration. Int J Gynaecol Obstet. 2003;81:93-102.

Weeks A, Lavender T, Nazziwa E, Mirembe F. Personal accounts of 'near-miss' maternal mortalities in Kampala, Uganda. BJOG 2005;112:1302-7.

Rahman MH, Akter HH, Khan Choudhury ME, Yusuf HR, Rochat RW. Obstetric deaths in Bangladesh 1996-1997. Int J Gynaecol Obstet 2002; 77:161-9.

Hofmeyr GJ, Say L, Gülmezoglu AM. WHO systematic review of maternal mortality and morbidity: The prevalence of uterine rupture. BJOG 2005;112:1221-8.

McCarthy M. What's going on at the World Health Organization? Lancet 2002;360:1108-10.

McCarthy M. A brief history of the World Health Organization. Lancet 2002;360:1111-14.

Nelson JP, Lavinder T, S Quenby et al. obstructed labour, Reducing maternal death and disability during pregnancy. Br Med Bull. 2003;67(1):191-204.

Fantu S, Segni H, Alemseged F. Incidence, Causes and Outcome of Obstructed Labor in Jimma University Specialized Hospital. Ethiop J Health Sci. 2010; 20:145-51.

Islam JA, Ara G, Choudhary FR. Risk factors and outcome of obstructed labour at a tertiary care Hospital. J Shaheed Suhraeardy Med Coll. 2012;4(2):43-6.

Nwogu-Ikojo EE, Nweze SO, Ezegwui HU. Obstructed labour in Enugu, Nigeria. J Obstet Gynaecol. 2008;28:596-9.

Meiah GS, EL-Nafaty AU, Massa AA, Audu BM. Obstructed labour: A public health problem in Gombe, Gombe State, Nigeria. J Obstet Gynaecol. 2003;23:369-73.

Aboyeji AP, Fawole AA. Obstructed labour in Ilorin, Nigeria. A one year prospective study. Niger Med Pract. 1999;38:1-3.

Sabyasachi mondal, fetomaternal outcome of obstructed labour Med Jour DY PATIL. Vol6 issue 2 146-50.

Ritu Gupta Obstructed labour: Incidence, causes and outcome. Int J Bio Med Res. 2012;3(3):2185-8.

Adhikari S, Dasgupta M, Sanghamita M. Management of obstructed labour; A retrospective study. J Obstet Gynaecol India 2005;55:48-51.

Dafaiiah SE, Ambago J, El-Agib F. Obstructed labour in a teaching hospital in Sudan. Saudi Med J. 2003; 24:1102-4.

Chuni N. Obstructed labour in Eastern Nepal. Singapore J Obstet Gynecol. 2008;39:1-7.






Original Research Articles