Dystocia: a continuing problem

ABSTRACT

A three year retrospective study was carried out at Sir Ganga Ram Hospital, Lahore, on 491 cases of dystocia, which formed 3.58% of 13,723 deliveries during the period. Of these 491 cases, 287 [58.45%] came with late obstructed labour and 204 [41.55%] with various types of prolonged labour. The commonest causes of dystocia were foetal malpositions and malpresentations in 172 [35.03%] patients and cephalopelvic disproportion in 167 [34.01%] cases. Five were in false labour; of the remaining, a large number of cases i.e., 372 [75.76%] came with abnormal length of labour with ruptured membranes. A total of 282 [58.02%] patients required a Caesarean section, while 83 [17.08%] had instrumental delivery and 55 [11.32%] were delivered normally. Infection was the most frequent maternal complication found in 297 [11.2%] patients. There were 6 maternal deaths [maternal mortality rate 17.04/1000 live births]. A total of 139 babies were stillborn, while 21 of the 352 live born expired within the first week; thus the perinatal loss was 160 or 329.21/1000. Important factors contributing to mortality were extreme age groups and parity, lack of proper antenatal and intrapartum care and mismanagement by traditional birth attandents