SHAZIA AHMED, IRUM NAZ, SHAZIA KHOKHAR, RAFIA BALOCH

ABSTRACT | Full Text Pdf

Introduction: Each year, 210 million women become pregnant, of whom 350,000- 500,000 die from complications during pregnancy or childbirth and 99 percent of them are from developing countries. Obstructed labour is not only one of the five leading causes of maternal death but also an important source of short and long term maternal morbidities (like Rectovaginal fistula, Vesicovaginal fistula), stillbirth or neonatal death due to asphyxia.

Material and Method : Prospective, observational, 06 months (1st November 2011 to 30th April 2012) study conducted at obstetric department of Sheikh Zaid Women Hospital (SZWH) Larkana -A community based teaching hospital.

Inclusion Criteria: all patients with obstructed labor in the period under review, with age ranging from 14-40 years, who consented for inclusion in the study.

Exclusion criteria: patients with preterm labor, APH, preterm Eclampsia or any other medical disorder were excluded Data was collected on printed performa after written, informed consent and included demography of patients, age at marriage , parity, antenatal care received or not, educational status, socioeconomic class, history regarding duration of labor, mode of delivery and maternal and fetal outcome, and data analyzed in standard fashion using SPSS version 17.

Results: A total of 100 patients who met the inclusion criteria were included in the study. The age of these patients ranged between 15 to 40 years, and majority of them were in their twenties. Parity ranged from 0-13, and 36 out of 100 were grand multipara. 50% patients were from rural areas, only 10% had received antenatal care at least once. The mean duration of labour was 40 hours, the most common cause of Obstructed labor was CPD as (60% patients), followed by malpresentation with malposition. Malpresentation alone (11%). 87 patients undergoing abdominal deliveries, 80 had lower segment caesarean section, 4 had repair of ruptured uterus, and 3 had Subtotal hysterectomy. 12 cases undergoing forceps deliveries, and one Ventouse. 95 % cases had serious maternal complications, Maternal sepsis being most common (30 cases), followed by PPH (20 cases). wound sepsis, burst abdomen and risk of fistula formation. One patient expired due to severe PPH. APGAR score was poor in 98% neonates, and 50 of these died either during the process of labour or within first 7 days of life.

Conclusion: OL is an important cause of maternal and fetal morbidity and mortality.