Fetomaternal Outcome of Obstructed Labor in a Tertiary Care Centre

Abstract

INTRODUCTION Obstructed  labor is the  leading cause of  hospitalization. It is a preventable obstetric complcation. However, it is a major cause  of  maternal  and  perinatal  morbidity  and mortality. The main  objective of the study was to find feto-maternal outcome in obstructed labor at tertiary care hospital UCMS-TH, Bhairahawa.

MATERIAL AND METHODS Eighty seven women  admitted with features of obstructed labor at our hospital were studied. By clinical examination, diagnosis of cephalopelvic disproportion, malpresentation, malposition, obstruction in birth canal, overdistended bladder, hematuria, rupture uterus and  supermoulding of fetal  head  was detected. Demographic profile of patients, mode of delivery, time interval between referral and admission, intervention done, intrapartum and postpartum  complications, maternal and fetal outcome were evaluated.

RESULTS There  were 87 cases  of  obstructed  labor among 1655 total deliveries. Most common cause for obstructed labor was cephalopelvic disproportion (34.4%) followed by malpresentation (19.5%) and  non  progress of   labor (17.2%). Majority of the patients were primigravida (43.6%) followed by multiparous (35.6%) and grand multipara (20.6%). Most of  cases were  unbooked  and referral from primary health centers (80.4%). PPH (41.2%), extension of uterine incision (17.4%), followed by sepsis, pyrexia and uterine rupture were common complications. Perinatal  morbidity  due  to  obstructed  labour requiring NICU admission was (33.9%) and perinatal mortality was (21.7%) mainly due to meconium aspiration, respiratory distress and septicemia.

CONCLUSION Cephalopelvic disproportion and primigravida were the commonest cause of obstructed  labour and associated with PPH, extension of uterine incision, uterine rupture, sepsis and neonatal ICU admission and even neonatal death.