DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20192457

Feto maternal outcome in obstructed labor: a tertiary centre study

Anshul Bansal, Ruchi Kalra

Abstract


Background: The number of maternal deaths as a result of obstructed labor is 8% globally but this number varies in developing country, it ranges 4-70% of all maternal deaths and it is also associated to high perinatal mortality rate. Objective of the study was to find out the proportion of obstructed labour cases and their feto-maternal outcome during last 3 years at tertiary level institute.

Methods: A cross sectional observation study was done at Department of Obstetrics and Gynecology, People’s College of Medical Sciences and Research Centre Bhopal. All pregnant women presenting with obstructed labor who delivered at our hospital during last 3 years duration (January 2015 to December 2017) were studied for their feto -maternal outcome.

Results: 53% cases had duration of trail more than 16 hours. 84% were referred from primary health centers of nearby rural areas. All  cases  of obstructed labor  delivered by cesarean section (100%). 44% were primigravida. 72% of cases had Cephalopelvic disproportion as the cause. 28% of cases had longer stay more than 7 days at hospital. 32% had  fever  during post operative period 12.5% cases had wound sepsis and 6% of cases required re-suturing of wound during post operative period. 72% baby's birth weight was between 3 to 3.4 kg. 94% of the babies survived where as 6% of babies were still birth. 16% of babies born to obstructed labor mother had APGAR less than 7 at 5 minutes of birth. 6% fetus were IUFD.

Conclusions: Cephalopelvic disproportion was the most common cause for obstructed labor. Timely identification of prolonged labor and timely referral and management at place where operation theatre, NICU and blood bank facilities are available can save the life of both baby and mother.


Keywords


Fetal death, Maternal morbidity, Obstructed labor, Postnatal complications

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References


Dunea G, Perman E. A royal pregnancy gone wrong birth, pregnancy, and obstetrics. Hektoen International J Human Fall. 2012;4(4). Available at: https://hekint.org/birth-pregnancy-obstetrics/. Assessed 15 April 2019.

World Health Organization. Education material for teachers of midwifery: midwifery education modules. 2nd ed. Managing prolonged and obstructed labor. 2008. Available at: https://apps.who.int/iris/bitstream/handle/10665/44145/9789241546669_4_eng.pdf?sequence=4&isAllowed=y. Assessed 6 April 2019.

Gessessew A, Mesfin M. Obstructed labour in Adigrat zonal hospital, Tigray Region. Ethiop J Health Dev. 2003;17(3):175-80.

Dolea C, AbouZahr C. Global burden of obstructed labour in the year 2000. Evidence and Information for Policy (EIP), World Health Organization, Geneva; 2003:1-17.

Cron J. Lessons from the developing world: obstructed labor and the vesico-vaginal fistula. Medscape Gen Med. 2016;5(3):14.

Henok A, Asefa A. Prevalence of Obstructed Labour among mothers delivered at Mizan Aman general hospital, South West Euthopia. A Retrospective study. J Womens Health Care. 2015;4(5):1-4.

Adeyoe IS, Dimejesi L, Onoho R, Bartholomew O, Ezeanochie M, Kalu C. Obstructed labour South East Nigeria Revisited. A multicenter study on maternal socio demographic and clinical co relates. J Womens Health Care. 2014;3(3):160.

Indra, Usharani N, Bendigiri M. A study of clinical outcome of obstructed labor. Int J Reprod Contracep Obstet Gynaec. 2017;6(2):439-42.

Ranjana, Sinha A. Incidences, causes and feto maternal outcome of obstructed labour at tertiary health care center. Int J Reprod Contracepm Obstet Gynaec. 2017;6(7):2817- 21.

Khatun J, Khanom K. Obstructed labour: A life threatening complications. Med Today. 2017;29(1):12-4.

Shaikh SR, Memon KN, Usman G. Obstructed labour; risk factors and outcome among women delivering in a tertiary care hospital. Professional Med J. 2015;22(5):615-20.

Ngonzi J, Bebell LM, Bazira J, Fajardo Y, Nyehangane D, Boum Y, et al. Risk Factors for vaginal colonization and relationship between bacterial vaginal colonization and in-hospital outcomes in women with obstructed labor in a Ugandan Regional Referral Hospital. Int J Microbiol. 2018:1-7.

Alkire BC, Vincent JR, Burns CT, Metzler IS, Farmer PE, Meara JG. Obstructed labor and caesarean delivery: the cost and benefit of surgical intervention. PLoS One. 2012;7(4):e34595.

Mondal S, Chaudhuri A, Kamilya G, Santra D. Fetomaternal outcome in obstructed labor in a Peripheral tertiary care hospital. Med J Dr. D.Y. Patil University. 2013;6(2):146-50.

Gleason RL, Yigeremu M, Debebe T, Teklu S, Zewdeneh D, Weiler M, et al. A safe, low-cost, easy-to-use 3D camera platform to assess risk of obstructed labor due to cephalopelvic disproportion. PLoS One. 2018;13(9):e0203865.

Wilson A, Truchanowicz EG, Elmoghazy D, MacArthur C, Coomarasamy A. Symphysiotomy for obstructed labour: a systematic review and meta-analysis. BJOG. 2016;123:1453-61.