Pattern of Obstructed Labour at a Public Sector University Hospital of Sindh, Pakistan

OBJECTIVE: To determine the frequency, risk factors, complications and outcome of obstructed labour in our setup. STUDY DESIGN: A retrospective study. SETTING: Obstetrics and Gynaecology Unit IV, Liaquat University Hospital, Jamshoro – Pakistan from January 2004 to December 2006 (three years). Methods: Patients’ records, labour room registers, operation theatre books and perinatal records were reviewed retrospectively to gather information about patients admitted with obstructed labour. RESULTS: Out of 2126 hospital deliveries during the study period, 44 (2.1%) were admitted with obstructed labour as an emergency. Only 13 (29.5%) had received antenatal care at some stage of pregnancy. Thirty-two (72.2%) patients belonged to rural areas. Mean duration of labour was 15.9±11.6 hours. Cephalo-pelvic disproportion in 22 (49.3%) cases was the most common risk factor of obstruction, followed by malposition/malpresentation in 19 (43.3%) cases. Caesarean section was the most common mode of delivery (81.1%). Three (6.8%) patients had ruptured uterus. Still birth rate was very high i.e. 14 (31%) and neonatal deaths were 4 (9%), while 26 (49%) babies survived with minor problems. CONCLUSION: Obstructed labour still poses a great maternal and foetal problem in our setup. Malpractice by untrained persons is a major factor. Most of these cases are preventable by proper antenatal care provided by properly trained persons.