Title: Obstructed Labor at a Tertiary Hospital in Nigeria: A Six-Year Review
Authors: Dr Bernard. O. Ewuoso, Dr Olalekan. D Awonuga, Dr Taofeek. A. Ogunfunmilayo, Dr Adesoji. S. Adebayo, Dr Olaide. R. Adenaya, Dr Olufemi. M Badmus
DOI: https://dx.doi.org/10.18535/jmscr/v12i08.08
Abstract
Introduction: Unlike most developed countries, obstructed labor with a dead fetus is still a reality in many developing countries, and it is a well-known cause of maternal and perinatal morbidity and mortality.
Objective: To highlight the characteristics of patients presenting with obstructed labor at a tertiary hospital and determine fetomaternal outcomes.
Methodology: A retrospective descriptive study of 45 cases of obstructed labor that were managed in a tertiary hospital from January 2009 to December 2014. Relevant information was extracted from patients’ case files, and the data obtained were analyzed.
Results: Obstructed labor constituted 0.75% of all deliveries. All patients were referred in, and thirty (2/3) of them were nulliparous, while 25 (55.6%) were between the ages of 16 and 25. Forty-one (91.1%) of the patients were delivered by emergency caesarean section, while four patients had exploratory laparotomy with uterine repair and bilateral tubal ligation. Thirty-eight (84.5%) of the babies weighed between 2.6-4kg and five (11.1%) weighed more than 4kg. Most of the patients, 91.1%, had prolonged hospital stay with 25% staying over 3 weeks postpartum before being discharged. Eight (17.8%) suffered severe birth asphyxia, and there were five perinatal and two maternal mortalities. The commonest complication was puerperal sepsis.
Conclusion: The study showed obstructed labor remains a cause of perinatal and maternal morbidity and mortality. Effective use of partographs in the peripheral centers, where all the women came from, would ensure early referral before labor became obstructed.
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