Pregnancy outcomein women presenting with obstructed labour in a Rural Hospital, Kenya
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Date
2015-02Author
Gichuhi, J Wanyoike
Soita M
Kiragu, JM
Language
enMetadata
Show full item recordAbstract
Background: Obstructed labour still remains a life – threatening catastrophe all over the world but mostly
in the developing countries. This, entirely preventable labour complication carrying a very high maternal
and neonatal morbidity and mortality is an indicator of the inadequacy and poor quality of obstetric care.
Obstructed labour is a major cause of maternal and perinatal morbidity and mortality accounting for an
estimated 8% of maternal deaths (4).
Objective: To determine the pregnancy outcome in mothers presenting with obstructed labour compared to
other parturient undergoing emergency caesarean section.
Study Design: Prospective cohort study.
Study setting: Kakamega Provincial General Hospital, Kenya.
Subjects and Methods: The study group comprised of 135 mothers with obstructed labour while the
comparison group also comprised of 135 mothers. Data collected was analyzed in SPSS version 15.0. Data
analysis entailed the use of descriptive statistics such as frequency distributions and cross tabulations using
the chi-square statistics.
The prevalence of obstructed labour was 6.8%. Women with obstructed labour had low educational
and socioeconomic status compared to the comparison group (p 0.032, 0.05). While 90% of mother with
obstructed labour had attended antenatal clinic only 49% had intended to deliver in hospital. Factors that
contributed to the delay in presenting to hospital included; lack of funds (27%), husband or mother in-law
refusal to give consent for hospital delivery (26%), lack of transport or ambulance at the primary and
secondary level facility (17%). Obstructed labour was associated with significant maternal morbidities;
ruptured uterus 6%, obstetric hysterectomy 5.2% (p 0, 0015), uterine tears 14.8% (p 0.000), post partum
haemorrhage 14.9% (p 0.000), wound sepsis 43% (p 0.0001) and puerperal sepsis 26.7%
(0.000).Obstructed labour was also associated with significant fetal morbidities; stillborns 18.5% (p
0.0001), low Apgar score 30%, newborn unit admission 26.6% (p 0.0001) and neonatal sepsis 16.5% (p
0.0001).
Conclusion: There is need to improve the educational and socio-economic status of the women.
Restructuring of Maternal child Health services should be done with particular attention to increasing
community awareness on safe obstetric care, promotion and improvement of appropriate technology,
counselling skill to health care providers through training, structured and quality health talks to the
antenatal clients on safe obstetric care.. Provision of accessible and effective safe obstetric care through
partnership with the community is paramount.
URI
http://www.eijst.org.uk/images/frontImages/gallery/Vol._4_No._2/9._77-86.pdfhttp://hdl.handle.net/11295/87113
Citation
Gichuhi, JW., Soita, M., & Kiragu, JM (2015). Pregnancy outcomein women presenting with obstructed labour in a Rural Hospital, Kenya. eijst, 4(2); pp.77-Publisher
University of Nairobi
Collections
- Faculty of Health Sciences (FHS) [10377]