OBSTRUCTED LABOUR - STILL A CHALLENGE

Background: Obstructed labour contributes to eight percent of maternal deaths in India. It is also one of the leading cause of perinatal morbidity and mortality in developing countries. Objective: To study the risk factors and fetomaternal outcome in obstructed labour at Sir Sunderlal hospital, BHU, Varanasi. This will help us to assess obstetric near miss and to develop strategies to decrease the complications resulting from obstructed labour. Materials & Methods: This was a one year retrospective study by reviewing the records of obstructed labour conducted from April 2015 to March 2016. Results: There were 52 cases of obstructed labour among 2381 total deliveries. Most common cause for obstructed labour was cephalopelvic disproportion (73%) followed by malposition/malpresentation (17.3%). Majority of the patients (69.2%) belonged to poor socioeconomic group. Sepsis (9.6%) and pyrexia (9.6%) were the common complications. Neonatal mortality was 30.8% and maternal mortality was 5.8%. Conclusion: Lack of health education, antenatal care, low socioeconomic condition, poor referral system and demographic factors are important contributory factors leading to adverse outcome of obstructed labour. This can be sorted out by proper antenatal care, improving health care delivery system especially in rural areas and timely referral of cases. Keywords: Antenatal care; Near miss; Obstructed Labour; Cephalopelvic disproportion; Maternal mortality