Frequency of Obstructed Labor in Teenage Pregnancy

Abstract

Aims: Teenage pregnancy has globally recognized as high risk pregnancy. Under grown pelvic bones at delivery pose greater risk of obstructed labour in such young girls resulting in poor feto-maternal outcome. Objective of this study was to determine the frequency of obstructed labor in teenage pregnancy and to know fetomaternal outcome. Methods: This Cross Sectional Observational study was conducted at department of Obstetrics and Gynecology unit I and II, Shaikh Zyed Women Hospital Chandka Medical College, Shaheed Mohtarma Benazir Bhutto Medical University Larkana Sindh Pakistan from 1st January 2010 to 31st December 2010. 468 women admitted with obstructed labour of all age groups, out of these which 257 patients were teenage mothers. Patients selected after fulfilling selection criteria. Obstructed labour in teenage patients wasdiagnosed on the basis of history of prolonged labour and clinical presentation. Demographical characteristics noted. Mode of the delivery and fetomaternal outcome was observed. Statistical analysis was performed using SPSS. 12 version. Results: Total deliveries in both units during study period were 9000. Among them 468(5.2%) patients found to have obstructed labour. Out of these 257(2.85% of total) patients were teenagers.. 82% (210) teengers were non booked and admitted in emergency while only 18 %(47) came through OPD having a single visit. Mean age was 16±2 years and parity was 2±1.5.Mode of delivery was LSCS in 84% (214) ,assisted vaginal delivery in 12% (32) and 4% (11)had spontaneous delivery with episiotomy. Cephalopelvic disproportion remained the commonest reason of obstruction (66%). 1.94% (5) of patients died of septicemia .PPH seen in 41% (105),1.1% (3) had scar dehiscence due to prolonged trial by untrained birth attendant.1.94% (5) patients developed vesicovaginal fistula later on. Perinatal mortality was around 54.6% (142) while 44.75 % (115) babies born alive. Conclusions: Adolescent pregnant women not only face pregnancy related problem but also they are prone to have obstructed labour due to their developing pelvic bones. Obstructed labour is one of the most common and preventable causes of maternal and perinatal deaths and disabilities. Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 1 / Issue 13 / Jan- June, 2012 / 37-40 DOI: http://dx.doi.org/10.3126/njog.v7i1.8834

Feto-maternal outcomes in obstructed labor in Suhul General Hospital, North Ethiopia

“…Eighteen (40.9%) of the babies were stillbirths or died immediately after delivery. This is lower than findings from studies done in Nigeria, Pakistan and Jimma Specialized Hospital in Ethiopia where the rate of perinatal loss among OL cases ranged from 50 to 62% (Fantu et al, 2010;Omole-Ohonsi and Belga, 2010;Gupta and Porwal, 2012;Shaikh et al, 2013;Shazia, et al, 2013). However; it is higher than findings from study conducted in six Ugandan hospitals where the rate was 14% (Kabakyenga et al, 2011).…”

“…From this study one mother has died making maternal mortality rate among OL cases to be 2.3%. This is similar to Pakistani study where maternal mortality rate among OL cases was 2% (Shaikh et al, 2013). However; it is slightly higher than Nigerian study and another Pakistani studies where the rate was 1% (Omole-Ohonsi and Belga, 2010;Shazia et al, 2013).…”

Obstetrical and Perinatal Outcomes of Teenage Pregnant Women Attending a Secondary Hospital in Hyderabad

“…There is conflicting evidence regarding hypertensive disorder in adolescent mothers, some studies reported higher risk of pre eclampsia in teenage mothers. A study conducted in Larkana Pakistan, reported higher frequency of hypertensive disorders compared to adult mothers [18] which was comparable with other studies [19], on the other hand another study reported that the risk of hypertensive disorder was significantly lower among adolescent mothers [13]. Frequency of abruption was 4.6% in our study population, however in multi country study the risk of antepartum hemorrhage was not significant in adolescence women [13].…”

Risk factors for obstructed labour in Eastern Uganda: A case control study

“…In our setting, many first time mothers are also young and it is possible that a link exists between prime parity and maternal age [2,11,12]. Although the current study was not powered to study this relationship, we know that young girls are prone to OL because they have an under developed pelvic cavity [2,13,37]. In addition, they have limited access to quality maternity services due to social and economic disadvantages and the fact that they usually conceive outside formal marriage.…”