Obstructed labour: incidence, causes and outcome

Authors: Ritu Gupta Sanjay Kumar Porwal
Int J Biol Med Res. 2012; 3(3): 2185-2188  |  PDF File

Abstract

Background- Obstructed labour is still a major cause of maternal morbidity and mortality and adverse outcome of newborn in low income countries.Objective- To review incidence, causes and outcome in the Gyne & Obst Dept, Govt Medical College, Jhalawar, Rajasthan, India. Methods- A retrospective one year (From Jan 2011 to Dec 2011) review of delivery registration records, operation theatre records and patients indoor records who underwent caesarean section for obstructed labour.Results- Over a period of one year, 70 cases of obstructed labour were managed among 6296 total deliveries. Only 34.28% of all cases had received antenatal care and majority 85.7% came from rural areas. 81.4% of the cases were primigravida. The most common cause of obstructions was cephalopelvic disproportion (63%) followed by malposition/malpresentation (29.9%). All patients were taken for LSCS. 5 patients were taken for subtotal hysterectomy for ruptured uterus. The most common post operative complication was sepsis (27.1%). 55.7% of newborns were admitted in the NICU after LSCS because all had low first minute APGAR score. Conclusion- Individual social-demographic and health system factors are strongly associated with obstructed labour and its adverse outcome. To improve the situation, better access to optional antenatal and intrapartum care, together with early referral of high risk patients must be facilitated.