Obstructed Labour in Adigrat Zonal Hospital, Tigray Region, Ethiopia
Amanuel Gessessew, Mengiste M Mesfin
Abstract
Amanuel Gessessew, Mengiste M Mesfin
Abstract
Background: Obstructed labour is a common cause of maternal and pernatal morbidity and mortality in developing countries. There are few data from Ethiopia, although the problem is believed to be common. Objective: To describe the frequency, causes, complications and treatment outcome of mothers with obstructed labour. Methods: a retrospective (April 1, 1993 – March 30, 2001) review of delivery registration books, operation theatre books and patients records. Results: Of 5,980 hospital deliveries during the study period 195(3.3%) were admitted for obstructed labour. Only 14.1% of all cases had received antenatal care, and the majority (88%) came from rural areas. Mean duration of labour was 45.4 hours for cases of obstructed labour. The most common cause of obstruction was cephalopelvic disproportion (64.9%) followed by malposition/malpresentation (32.5%). Caesarean section was performed in 88 of the 195 cases (46.1%), craniotomy in 31(16.2%), instrumental delivery in 27 (14.1%), hysterectomy in 28(14.6%) and repair of ruptured uterus in 17(8.9%). Maternal and neonatal fatality rates were 3.7% and 55.5% respectively. Serious complication increased with parity. Conclusion: The incidence and complications of obstructed labour are remarkably high. To improve the situation better access to optimal antenatal and intrapartal care, together with early referral of high-risk patients must be facilitated. Ethiop.J.Health Dev. 2003;17(3):175-180
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Background: Obstructed labour is a common cause of maternal and pernatal morbidity and mortality in developing countries. There are few data from Ethiopia, although the problem is believed to be common. Objective: To describe the frequency, causes, complications and treatment outcome of mothers with obstructed labour. Methods: a retrospective (April 1, 1993 – March 30, 2001) review of delivery registration books, operation theatre books and patients records. Results: Of 5,980 hospital deliveries during the study period 195(3.3%) were admitted for obstructed labour. Only 14.1% of all cases had received antenatal care, and the majority (88%) came from rural areas. Mean duration of labour was 45.4 hours for cases of obstructed labour. The most common cause of obstruction was cephalopelvic disproportion (64.9%) followed by malposition/malpresentation (32.5%). Caesarean section was performed in 88 of the 195 cases (46.1%), craniotomy in 31(16.2%), instrumental delivery in 27 (14.1%), hysterectomy in 28(14.6%) and repair of ruptured uterus in 17(8.9%). Maternal and neonatal fatality rates were 3.7% and 55.5% respectively. Serious complication increased with parity. Conclusion: The incidence and complications of obstructed labour are remarkably high. To improve the situation better access to optimal antenatal and intrapartal care, together with early referral of high-risk patients must be facilitated. Ethiop.J.Health Dev. 2003;17(3):175-180
Key concepts: Cephalopelvic disproportion, Obstructed labour, Medicine, Caesarean section, Referral, Obstetrics, Complication, Case fatality rate