Obstructed Labor: Still a Harsh Reality

Abstract

Background: Obstructed labor is one of the preventable causes of maternal and perinatal morbidity & mortality. If detected and managed in time, optimum results will be obtained for both mother & baby. Aim: To assess the incidence, socio-demographic characteristics, causes and outcomes of obstructed labor in pregnant patients attending Mardan Medical Complex, Mardan.Methodology: This descriptive cross sectional study was conducted at Gynaecology and Obstetrics Department of Mardan Medical Complex, Mardan from February to July 2017. All pregnant patients of any age, parity, booking status who presented at term with diagnosis ofobstructed labor or developed obstructed labor in same hospital were included. Detailed history, perabdominal and per vaginal examination were performed and cesarean section done in all cases, noting all the intra and postoperative complications. Data was analyzed by SPSS 20.0. Results: Incidence of obstructed labor was 1.8% as 61 patients presented with diagnosis of obstructed labor. The most common age group was 21- 30 years where 40(65.57%) patients fell. Mean age was 26.5±4.2 years and 32(52.4%) women were primiparous. 54(88%) patients were rural citizens and 57(93.44%) were nonbooked cases. Cephalopelvic disproportion was seen as cause of obstruction in 37(60.6%) cases, followed by malposition in 12(19.6%) and malpresentation in 10(16.3%) cases. Intra and postoperative complications were febrile morbidity in 21(34.4%), uterine rupture in 14(23%), wound sepsis in 10(16.3%) and urinary tract infections in 7(11.4%) cases. Maternal mortality was seen in 2(3.2%) and perinatal mortality in 21(34.4%) babies. Conclusion: Improvement in nutrition, timely diagnosis, early referral and intervention can help in reduction of this preventable cause of maternal and perinatal morbidity and mortality.