Incidence, Causes and Outcome of Obstructed Labor in Jimma University Specialized Hospital

Abstract

BackgroundObstructed labor is one of the common preventable causes of maternal and perinatal morbidity and mortality in developing countries. Africa has the highest maternal mortality in the world, estimated at an average of about 1,000 deaths per 100,000 live births. This study was conducted to assess the incidence, causes and outcome of obstructed labor in Jimma University Specialized Hospital.MethodsHospital-based, cross-sectional study was conducted on all mothers who were admitted and delivered in the labor ward of Jimma University Specialized Hospital from November 1, 2008 to April 30, 2009. Data was collected using structured questionnaire and checklist, and then analyzed using SPSS for windows version 16.0.ResultsThe incidence of obstructed labor was 12.2%. Out of these 61.5% did not have antenatal care follow-up. Most of the cases, accounting for 145(81.0%), 160 (89.4%) and 170 (93.9%) were referred from health centers, visited the hospital after at least 12 hours of labor and came from a distance of more than 10 kilometers, respectively. The causes of obstructed labor were cephalo-pelvic disproportion in 121(67.6%) and malpresentation in 50 (27.9%) of the cases. The commonest maternal complications observed were uterine rupture in 55 (45.1%) and sepsis in 48 (39.3%) of the cases with complications. Forty-five point eight percent of fetuses were born alive and all had low first minute APGAR score.ConclusionThe incidence of obstructed labor was high with high rate of complications. The antenatal care follow-up practice was also found to be low. Improved antenatal care coverage, good referral system, and availing comprehensive obstetric care in nearby health institution are recommended to prevent obstructed labor and its complications.

Maternofetal outcome in obstructed labour in a tertiary care hospital

“…Mostly the patients were primigravida (73.3%) and of age group 19-24 years (64.9%). The incidence of obstructed labour was higher in unbooked patients (78.1) comparable to study done by Shimelis and Fantu et al 10 86.5% of the patients who presented with features of obstruction were from rural areas showing lack of proper healthcare facilities.…”

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

“…This figure is higher than study done in India where only 7.1% of OL cases have developed uterine rupture (Omole-Ohonsi and Belga, 2010). It is however; lower than findings from a study done in Jimma Specialized Hospital in Ethiopia, where uterine rupture has complicated 45.1% of OL cases (Fantu et al, 2010).…”

“…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).…”

“…The main cause of obstructed labor is cephalo pelvic disproportion which is usually a result of under nutrition during childhood and early childbirth resulting in small pelvis (Dolea and AbouZahr, 2003, Al-Harazi, 2006, Fantu, Segni et al 2010, Ara 2011, Agrawal et al 2014.…”

“…Moreover, the impact of obstructed labor on the lives of the fetuses is very significant and it is responsible for high proportion of perinatal death. Furthermore, survived children suffer from long-term complications like cerebral palsy and developmental disabilities (Lawn et al, 2005, Fantu et al, 2010Kabakyenga et al, 2011;Bayou and Berhan, 2012). OL has contributed 8% to the estimated 289,000 maternal death occurred in 2013 globally, 99% of which were in low income countries (Dolea and AbouZahr, 2003;Wall et al, 2005;Gibbons et al, 2010;Khooharo et al, 2013).…”