Maternal And Perinatal Outcome In Obstructed Labour

ABSTRACT

Background– Obstructed labour is a life threatening obstetric complication associated with significant maternal and fetal morbidity and mortality .Maternal mortality is largely due to PPH, puerperal infection or rupture uterus and perinatal mortality is mainly due to asphyxia. Methods– Prospective study of two years duration with sample comprised of 250 cases of obstructed labour randomly selected from all patients admitted to labour room with obstructed labour were included in this study. Results – The incidence of obstructed labour was 3.67% .72% were referral cases. Majority were primigravida(60.8% ) and between21–30 years(72.4%) .Common causes were Cephalopelvic disproportion( 54.4%) , malpresentation and malposition( 42%) and fetal malformation (1.6%).Delivery was by Caesarean section (80.4 %), forceps application ( 6.8 %)and destructive operations (1.6% ).Out of 28 cases of ruptured uterus,17 (6.8%) and11(4.4%) were managed by subtotal hysterectomy and uterine repair respectively.Maternal morbidity was 86.4% , causes being Puerperal pyrexia (37.6%) , post partum haemorrhage (20.8%) and wound infection (14.4%). Maternal deaths (1.6%) due to endotoxic shock and primary PPH.Perinatal mortality was21.14%. Commonest causes of neonatal morbidity were birth asphyxia (38.33%) of live births, jaundice (29.96%) ,septicaemia (18.94%) and Meconium aspiration syndrome (13.66%). Most of neonatal deaths were due to severe birth asphyxia (54.17%) followed by septicaemia (20.83%) Conclusion – Obstructed labour is a frequently encountered obstetric complication associated with very high maternal and perinatal morbidity and mortality. It can be prevented by providing good nutrition and optimal obstetric care .Effective antenatal care and early detection of risk factors and timely referral will prevent the complication due to obstructed labour.