Even in 21st Century Still Obstructed Labor Remains Life Threatening Condition

Abstract

Background and Objectives:  Obstructed labor is a life threatening complication of pregnancy, almost disappeared from the western world, but is still one of leading cause of maternal morbidity and mortality in developing countries. This study was conducted to ass-ess the frequency of complications in obstructed labo-ur (OL) and outcomes of such patients with obstructed labour and give recommendations for remedial mea-sures.

Setting and Design:  This descriptive study was con-ducted on 40 patients having OL, in the Department of Obstetrics and Gynecology at Muhammad Medical College Hospital (MMCH) Mirpurkhas, from 1^st July 2007 to 30^th June 2010.

Methods:  Patients coming through the main emer-gency to labour room (LR) or already admitted in LR with a history of labor pains more 12 hours were inclu-ded in this study. Patients with previous caesarean sec-tion and myomectomy were excluded from. Written consent was taken from patients for using information regarding history, clinical examination and related investigations. The data was analyzed in SPSS 10.

Result:  Mean age was 27.7 ± 5.9, while majority bel-onging to age group of 20 – 30 years, mostly found in primigravidae; the mean duration of labour was 15.9 ± 11.6 hours. Cephalopelvic disproportion (CPD) was the most common risk factor found in 27 (67.5%) cases. Caesarean section was the most common mode of delivery 29 (72.5%) cases. Eight (6.8%) patients had rupture uterus. Only one (2.5%) patient was primi-gravida with incomplete uterine rupture in obstructed labour with brow presentation. Still birth rate was very high 18 (45%) and neonatal deaths were 14 (35%), while 8 (20%) babies survived. Four (10%) patients
died due to complications of obstructed labour.

Conclusion:  CPD was the predominant cause of OL, more in young age group. Morbidity and mortality were more common in patients with duration of labor pains more than 18 hours. Further studies should be conducted for prevention, recognition and timely man-agement of risk factors to reduce the fatal outcomes.

Key Words:  Obstructed labour, Cephalopelvic dis-proportion, Rupture uterus.