Incidence, Causes and Outcome of Obstructed Labor in Darbhanga Medical College & Hospital, Laheriasarai, Bihar

摘要

Background : Obstructed labor is one of the common preventable causes of maternal and perinatal morbidity and mortality in developing countries. India has the highest maternal mortality in the world, estimated at an average of about 1,000 deaths per 100,000 live births. This study was conducted to assess the incidence, causes and outcome of obstructed labor in DMCH, Laheriasarai, Bihar. Methods : Hospital-based, cross-sectional study was conducted on all mothers who were admitted and delivered in the labor ward of Obstetrics and Gynaecology department of Darbhanga Medical College & Hospital from November 1, 2015 to October 30, 2016. Data was collected using structured questionnaire and checklist, and then analyzed using SPSS for windows version 16.0. Results: The incidence of obstructed labor was 12.2%. Out of these 61.5% did not have antenatal care follow-up. Most of the cases, accounting for 145(81.0%), 160 (89.4%) and 170 (93.9%) were referred from health centers, visited the hospital after at least 12 hours of labor and came from a distance of more than 10 kilometers, respectively. The causes of obstructed labor were cepbalo-pelvic disproportion in 121(67.6%) and malpresentation in 50 (27.9%) of the cases. The commonest maternal complications observed were uterine rupture in 55 (45.1%) and sepsis in 48 (39.3%) of the cases with complications. Forty-five point eight percent of fetuses were born alive and all had low first minute APGAR score. Conclusion : The incidence of obstructed labor was high with high rate of complications. The antenatal care follow-up practice was also found to be low. Improved antenatal care coverage, good referral system, and availing comprehensive obstetric care in nearby health institution are recommended to prevent obstructed labor and its complications.