Paper Title: Retrospective analysis of fetomaternal outcome of obstructed labour in a low resource setting in Port Harcourt
Authors: Bassey G, Henderson-Jumbo C.
Background: Obstructed labour is still highly prevalent in developing countries and almost non-existent in developed countries. It is a major cause of adverse pregnancy outcome especially in low resource setting. Objective: To determine the prevalence and fetomaternal outcome of obstructed labour, assess the role of destructive operations in the management of obstructed labour and to make recommendations with the view of improving outcome. Methodology: This was a retrospective study involving 118 patients with obstructed labour managed at the University of Port Harcourt Teaching Hospital (UPTH) from 1 June, 2012 to 31 May, 2017. A proforma was used to obtain necessary information from the case files of the patients and the generated data was analysed using SPSS. Chi-square test was used to compare categorical variables with P value < 0.05 regarded as significant. Results: The prevalence of obstructed labour was 1.6%. Most of the women were between 21-35 years and most had secondary level of education while nulliparity accounted for 73.8%. Most (80.5%) patients had no formal antenatal care (unbooked). Cephalopelvic disproportion was the main cause of obstructed labour seen in 104 (88.1%). Emergency caesarean section was performed for 102 (85.6%) patients with obstructed labour. Nine (42.9%) out of 21 patients had destructive operations performed. Sixty-nine (58.5%) patients had post-operative complications; puerperal and wound sepsis were the most common post-operative complications. Fetal demise occurred in one out of every three cases of obstructed labour irrespective of booking status. Booking status was not significantly associated with adverse fetomaternal outcome. Conclusion: There is an urgent need to sensitized and encourage pregnant mothers to have specialized care during pregnancy and labour as most cases of obstructed labour were recorded amongst the unbooked mothers. The act of destructive operations should be encouraged and taught to resident doctors.